Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Robotic Hernia Surgeon · Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad
In short
Some people notice a soft bulge in an old operation scar. It may be months after the surgery, or many years. It often grows when they stand or cough and goes flat when they lie down.
This is usually an incisional hernia. This page explains why it happens and what can be done.
During an open operation, the surgeon cuts through the tough layer of the belly wall and stitches it closed at the end. The skin heals on top. Underneath, the deeper layer has to knit together too.
If that deeper layer does not heal fully, a gap forms. Fat or bowel then pushes out through it, under the skin of the scar.
A healed layer is never quite as strong as the wall was before. Day after day, coughing, lifting and straining push on it. Weight gain stretches it. Over time a weak spot can open up.
Long cuts in the middle of the belly and emergency operations carry the highest risk. A wound infection after the first surgery raises it further.
Things that raise the risk of a hernia in a scar
| Risk | Why it matters | Can it be changed? |
|---|---|---|
| Wound infection after the first operation | Weakens the healing layer | Not afterwards |
| Smoking | Slows healing and weakens tissue | Yes, stop before a repair |
| Extra body weight | Puts constant strain on the scar | Yes, often |
| Diabetes | Slows healing | Yes, keep sugar in control |
| Long-standing cough or straining | Pushes on the scar again and again | Yes, treat the cause |
A new bulge in an old operation scar? Bring the details of your earlier surgery and any scan report.
Warning signs that need help the same day
Go to an emergency department if these happen.
An incisional hernia does not close on its own. Most grow slowly. A larger gap needs a bigger repair, so many surgeons suggest planning repair while it is small.
The surgeon closes the gap and supports it with a mesh. Keyhole or robotic repair, through small cuts away from the old scar, is often possible.
Most appear within the first few years, but some show up much later. A new bulge in any old scar is worth a check.
Any operation with a cut through the belly wall. They are more common after long cuts in the middle of the belly and after emergency surgery.
Most are not urgent, but bowel can get trapped, more so when the opening is narrow. Sudden pain with a hard lump needs urgent care.
No. A binder may make you more comfortable, but it does not close the gap. The hernia usually grows slowly over time.
The gap is closed and supported with a mesh. Keyhole or robotic repair is often possible, even for some larger hernias.
The main page on this site is robotic hernia surgery in Ahmedabad. These cover the neighbouring questions.
Where to find us
Dr Harsh Shah, MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Shah's Gastro, Cancer & Robotic Surgery Centre
Apollo Hospital, Bhat, Gandhinagar
Gota OPD, Ahmedabad
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