VSR 421: Regional Veterinary Surgery (2+1)

VENTRAL HERNIA

• Ventral or lateral adnominal hernia is the term used to describe a hernia through any part of the abdominal wall other than a natural orifice. This condition is common in horse,goat  and cattle and is generally acquired in nature.

Etiology

• Any trauma – horn thrust in cattle, violent contact with blunt objects, weakening of the abdominal muscle
• Violent straining during parturition – common in sheep
• Ventral or lateral hernia is usually seen along costal arch, high or low in flank and between the last few ribs in the ventral abdominal wall near the midline

Signs 

• Size of the hernial ring varies in diameter. The hernial swelling is usually very prominent.
• It is difficult to palpate the hernial ring in initial stages due to oedema or haematoma surrounding tissue.
• Strangulation is very rare. Nature of hernial contents depends on the site of herniation.

Treatment 

• When the hernia is harmless – herniorrhaphy is elective; not an emergency.
• It is advisable to delay the surgical repair until the inflammation subsides.
• Prolonged delay may cause complications due to adhesions between the displaced viscera and subcutaneous tissue.
• If hernia is complicated (due to incarceration/ strangulation) immediate surgical intervention is required.

Technique

• An elliptical or linear incision is made over the hernial swelling. The contents are reduced.

Dorsal recumbency	Hernial ring

• The peritoneal sac is ligated or sutured close to the ring and amputated.

Herniorrhaphy	Prolene mesh

•  The hernial ring is debrided and sutured using overlapping sutures with a non absorbable suture material.

Onlay grafting

• Hernioplasty using prolene mesh as onlay graft.
• The skin incision may be sutured with a vertical mattress sutures.

Post operative care

• Amount of feed should be restricted.
• Supportive bandage may be placed around the abdomen. Tear of scar tissue during parturition and recurrence of hernia may occur in some cases.