Parietal Disaster

  • Chowbey Pradeep


Incisional hernia (IH) is defined by the European Hernia Society (EHS) as “any abdominal wall gap with or without bulge in the area of postoperative scar perceptible or palpable by clinical examination or imaging” [1]. The incidence of incisional hernia is around 20% after abdominal wall surgeries [2]. The risk factors associated with development of IH include patient-related factors, nature of primary surgery, and biological factors. Patient-related factors include age >60 years, male gender, [3–6] obesity with increased BMI > 25 kg/m2 [5], and patient comorbidities (diabetes, chronic lung disease, immunosuppression in organ transplant patient, chemotherapy, and steroid therapy) [7–10]. Surgery related risk factors for incisional hernia include emergency operations [9], bowel surgery, re-laparotomy, burst abdomen with evisceration [11–14], wound infection, wound dehiscence, midline abdominal incision has higher risk for developing IH compared to transverse and oblique incisions, respectively [4, 11]. Biological factors include enzyme defects, smoking, and nutritional deficiencies [15]. The occurrence of IH is multifactorial in nature. Laparoscopic approaches have also contributed to the development of incisional hernia. Laparoscopy-related factors are diameter of the port size >10 mm, multiple insertions, long duration of surgery, inadequate evacuation of pneumoperitoneum, unrelaxed abdominal wall at the end of the procedure, and increased abdominal pressure at the end of surgery [16].


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Chowbey Pradeep
    • 1
    • 2
    • 3
  1. 1.Max Institute of Minimal Access, Metabolic and Bariatric SurgeryMax Hospital, SaketNew DelhiIndia
  2. 2.Surgery and Allied Surgical SpecialtiesMax Hospital, SaketNew DelhiIndia
  3. 3.Max Super Specialty Hospital, SaketNew DelhiIndia

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