Dr. Solon Gonçalves Souza Menezes
Professor of Surgery — FAMED UFU · Robotic Surgery Certification (Intuitive / Albert Einstein Hospital) · Practices at Hospital UMC and Hospital Mater Dei Santa Genoveva, Uberlândia, Brazil · +55 (34) 99341-0915
Incisional hernia is an abdominal wall hernia that develops at the site of a prior surgical scar, where the musculature and connective-tissue layers did not heal completely, creating a point of weakness through which abdominal content can protrude. It is one of the late complications most associated with open abdominal surgery, although it can also occur, less frequently, after laparoscopic or robotic access, usually at the trocar insertion sites. Factors that increase the risk of its development include obesity, diabetes, smoking, corticosteroid use, malnutrition, surgical site infection in the original surgery, multiple prior surgeries in the same region, and conditions that raise intra-abdominal pressure, such as chronic cough or early physical exertion after surgery. Incisional hernias can vary considerably in size and location, and are classified according to these criteria, which helps guide surgical planning.
Diagnosis usually begins with a physical examination, which identifies a bulge in the scar area, generally more evident with straining or the Valsalva maneuver, and which may or may not be reducible. Imaging exams — abdominal ultrasound and, especially, CT — help precisely define the size and number of defects in the abdominal wall, the presence of adhesions, and the volume of herniated content, information that is important for planning the reconstruction, especially in larger, recurrent hernias or those associated with loss of domain of the abdominal cavity.
Surgical correction generally involves releasing adhesions between the abdominal content and the wall, reducing the herniated content back into the cavity, closing the muscular defect whenever feasible, and reinforcing the wall with mesh, preferably positioned in a retromuscular plane, a placement frequently used in abdominal wall reconstructions. In larger defects, it may be necessary to combine abdominal wall component-separation techniques to allow closure without excessive tension. Through the robotic approach, these steps are carried out with a magnified three-dimensional view and articulated instruments that facilitate fine dissection in planes with adhesions and suturing in confined spaces, generally through smaller incisions than open surgery. The choice of technique, mesh type, and any need for component separation is always individualized, taking into account imaging findings, surgical history, and each patient's clinical condition — an assessment carried out by a surgeon with specific training in robotic surgery and abdominal wall reconstruction.
Book a consultationWhat to expect before and after surgery.
Preoperative preparation
Preoperative preparation for robotic incisional hernia surgery generally includes a clinical evaluation and routine exams, which may vary according to age, health history, and the complexity of the case. A period of fasting before the procedure is generally recommended and, when necessary, temporary adjustments to ongoing medications, always under individualized medical guidance. Habits such as quitting smoking and keeping associated conditions, like diabetes or excess weight, under control tend to be recommended when applicable, as they can influence healing. Each case is evaluated individually in consultation, and the responsible physician determines the specific preparation needed.
Recovery and postoperative care
Recovery after robotic incisional hernia surgery generally involves pain control with prescribed medication and a gradual resumption of activities, respecting the limits set by the medical team. Length of hospital stay and the pace of return to daily activities can vary considerably according to the extent of the repair, the size of the hernia, and each patient's clinical condition. Wound care and use of an abdominal belt or binder, when indicated, are generally part of the postoperative instructions, along with avoiding intense physical exertion for a period. Follow-up visits allow progress to be monitored and recommendations to be adjusted as needed for each case.
Common questions about this procedure.
Is robotic incisional hernia surgery performed under general anesthesia?+
Yes, it is generally performed under general anesthesia, with an anesthesiology team present throughout the procedure. The type of anesthesia and specific precautions are always defined during the individualized pre-anesthesia evaluation for each patient.
How long does the surgery take?+
Duration can vary according to the size and location of the hernia, the presence of adhesions from previous surgeries, and the complexity of the abdominal wall reconstruction. In general, procedures of this type tend to take a few hours, and may take longer in more complex cases.
Is hospitalization required after surgery?+
Yes, a period of hospitalization is generally recommended for observation, pain control, and monitoring of initial recovery. The exact length of hospital stay varies according to each patient's progress and is determined by the medical team.
How much rest is needed right after surgery?+
In the first few days, relative rest is generally recommended, avoiding physical exertion and heavy lifting, with a gradual resumption of light activities according to medical guidance. The pace of this progression varies from person to person.
When can I go back to work?+
Return to work depends on the type of activity performed — whether lighter or physically demanding — and each patient's individual healing progress. This period can range from a few days to a few weeks, and clearance is always assessed case by case at follow-up visits.
When can I drive again?+
It is generally recommended to wait until pain is adequately controlled and there is enough range of motion to react safely while driving. There is no single timeframe that applies to all patients, and this clearance is usually discussed at follow-up visits.
When can I resume physical exercise?+
More intense physical activities, especially those involving the abdominal muscles, tend to be resumed gradually, generally after medical clearance at follow-up visits. The time needed for complete healing of the abdominal wall can vary according to the case.
What care is recommended for the surgical wound and use of an abdominal binder?+
It is generally recommended to keep the surgical area clean and dry, watching for signs such as redness, swelling, or unusual discharge. Use of an abdominal belt or binder, when indicated, helps support the abdominal wall during healing, but specific instructions vary according to the technique and extent of the repair performed.
Is there a risk of the hernia coming back (recurrence) after surgery?+
Yes. As with any hernia repair, there is a possibility of recurrence, which may be related to factors such as the size of the original defect, the technique and type of mesh used, and each patient's individual healing characteristics. The robotic approach aims to reduce this risk through greater precision in mesh placement and suturing, but no surgical technique completely eliminates this possibility.
What is the difference between robotic surgery and conventional open or laparoscopic surgery for an incisional hernia?+
In robotic surgery, the surgeon operates from a console, controlling articulated instruments with magnified three-dimensional vision, which can facilitate tissue handling and placement of the reinforcement mesh in more complex cases, generally through smaller incisions than open surgery. The best technique for each patient depends on the surgeon's individual assessment.
Is mesh always necessary to repair an incisional hernia?+
In most cases of incisional hernia, the use of reinforcement mesh is indicated to support the abdominal wall and reduce the risk of recurrence. However, the need for mesh, its type, and how it is positioned depend on the characteristics of each hernia and are determined during the surgical evaluation.
Does robotic surgery usually cause less pain than open surgery?+
In general, minimally invasive techniques such as robotic surgery tend to be associated with less immediate postoperative pain and faster recovery compared to open surgery. Even so, perception of pain varies from person to person and also depends on the complexity of the repair performed.
Hospital facilities in Uberlândia, Brazil.
Hospital Mater Dei Santa Genoveva
Av. Vasconcelos Costa, 967 — Martins, Uberlândia-MG
Open in Google Maps →Content reviewed by Dr. Solon Gonçalves Souza Menezes — CRM-MG 79366, RQE 60355 (GI Surgery), RQE 44656 (General Surgery). Professor of Surgery at FAMED-UFU and Supervisor of the General Surgery Medical Residency Program at HC-UFU. ORCID. Last reviewed: September/2026.
- Peñafiel JAR, Valladares G, Rodrigues ACLF, et al. Robotic-assisted versus laparoscopic incisional hernia repair: a systematic review and meta-analysis. Hernia. 2024;28(2):321-332. doi:10.1007/s10029-023-02881-1
- Costa TN, Tustumi F, Ferros LSM, et al. Robotic-assisted versus laparoscopic incisional hernia repair: differences in direct costs from a Brazilian public institute perspective. Arq Bras Cir Dig. 2023;35:e1714. doi:10.1590/0102-672020220002e1714
- Costa TN, Abdalla RZ, Tustumi F, Ribeiro Junior U, Cecconello I. Robotic-assisted compared with laparoscopic incisional hernia repair following oncologic surgery. J Robot Surg. 2022;17(1):99-107. doi:10.1007/s11701-022-01403-y
- Warren JA, Love M. Incisional Hernia Repair: Minimally Invasive Approaches. Surg Clin North Am. 2018;98(3):537-559. doi:10.1016/j.suc.2018.01.008