Ventral, Incisional, and Umbilical Hernias: What They Are and How I Fix Them

By Dr. Rashna Ginwalla, Clearwater Advanced Surgical Associates, LLC

A ventral hernia is a bulge in the abdominal wall — tissue pushing through a weak spot in the strength layer (fascia) of the wall of your midsection. These hernias go by different names depending on where they occur: incisional hernias develop at the site of a previous surgical incision; umbilical hernias develop at or near the belly button; epigastric hernias occur between the belly button and the breastbone. Different locations, same underlying problem.

If you've noticed a bulge in your abdomen that wasn't there before — or that's been there a while and is getting more bothersome — here's what you should know.

Why they happen

The abdominal wall is a complex layer of muscle and connective tissue that holds your organs in place and generates the core strength for nearly every movement you make. Any place where there's a natural opening (like the belly button) or where the tissue was cut and repaired (like a surgical incision) can become a point of weakness over time.

Incisional hernias are a known risk after abdominal surgery — they can appear months or years after an operation, even after one that went smoothly. Umbilical hernias are extremely common and can be present from birth or develop later in life from increased abdominal pressure (pregnancy, chronic coughing, straining). Carrying extra weight, a previous hernia repair, and certain connective tissue conditions can all increase the risk.

When surgery is the answer

Not every hernia needs to be repaired immediately. Small hernias that cause no symptoms can sometimes be watched. But most hernias grow over time, and the larger they get, the more complex the repair becomes. The most serious risk — though uncommon — is strangulation, where the herniated tissue gets trapped and loses its blood supply. That's an emergency.

I generally recommend repair when a hernia is causing pain or discomfort, when it's growing, when it's interfering with daily activity, or when it poses a meaningful strangulation risk given its size and type. When we meet, I'll assess your hernia specifically and give you a clear recommendation; it may not require surgery at that time! .

What the operation involves

I repair most ventral hernias using a minimally invasive approach — laparoscopic or robotic — through several small incisions. I work inside the abdomen, returning the herniated tissue to its proper position and then placing a piece of surgical mesh to reinforce the repair. Mesh reduces the risk of recurrence significantly; without it, hernias come back at a much higher rate.

For larger or more complex hernias, an open repair through a longer incision may be necessary. The recovery is more involved, but the technique is well-established and highly effective.

A note on mesh, since I know it comes up. The concerns you may have read about online are largely tied to older products and uses in other procedures. For abdominal wall repair, modern surgical mesh is safe, well-studied, and the standard of care. I'll walk you through exactly what's being used and why at your consultation.

What recovery looks like

Recovery from ventral hernia repair varies depending on the size of the hernia and the approach used — minimally invasive repairs heal significantly faster than open ones.

Swelling is normal. The area around the repair will be swollen and may look different from before surgery for several weeks. You may also feel a firmness or ridge under the incision — that's scar tissue and mesh integrating, which is expected and resolves over time.

Lifting restrictions. This is the most important part of your recovery. The mesh integrates with your tissues over several weeks, and lifting too much too soon increases the risk of recurrence. For the first two weeks: nothing heavier than ten pounds. Gradually increasing after that, with full clearance at my discretion at your follow-up, typically at six to eight weeks for larger repairs.

Support garment. I often recommend an abdominal binder — a snug wrap worn during waking hours — for several weeks after surgery. It reduces swelling, supports the repair, and makes movement more comfortable.

Returning to work. Desk jobs: typically one to two weeks. Light physical work: two to four weeks. Heavy labor: four to eight weeks depending on the complexity of the repair.

No core exercises until cleared. Sit-ups, crunches, planks — hold off on those until I specifically tell you it's safe. Protecting the repair comes first.

When should you come see me?

If you have a bulge in your abdominal wall — whether it's new, slowly growing, or starting to cause discomfort — it's worth getting it evaluated. Some hernias can be watched; others need repair. You're better off having that conversation now, when the repair is simpler, than later when it's larger.

If you've had an abdominal hernia repair before and you're concerned about a recurrence, come in. I can assess whether the repair is holding or whether something needs to be addressed.

Call the office at (208) 985-6179, or request an appointment through the patient portal.

This page is a summary. After your consultation, I'll provide you with a detailed packet covering pre-operative preparation, the day of surgery, and post-operative care.