An abdominal hernia is one of the most common reasons for visiting a surgeon. At the same time, patients often mean different conditions by this term: a bulge in the abdominal area, discomfort during physical strain, a sensation of a “weak spot,” or pain that appears and disappears. In everyday language, it is convenient to call all of this by one term, but from a medical perspective it is important to understand exactly what is being discussed. During consultations, I regularly see that similar complaints may hide conditions that are fundamentally different and require different approaches.
My position as a surgeon is clear: an abdominal hernia is always an anatomical defect of the abdominal wall, not a “strain” and not a “pulled muscle.” That is why the most reasonable step is not to guess based on sensations, but to clarify the hernia type and the risks during an in-person consultation.
Over the years of practice, I have repeatedly seen that the earlier a person begins to understand their problem, the calmer and more conscious the treatment process becomes. A hernia rarely appears suddenly – as a rule, it is preceded by certain changes in tissues and loads on the abdominal wall. In most cases, these changes accumulate gradually and remain unnoticed for a long time, which is why the first symptoms are often perceived as something temporary. These processes can be explained in simple terms, without complex diagrams or medical textbooks.
In this article, I will explain what is usually meant by an “abdominal hernia,” why it develops, what symptoms it may cause, and which types of hernias most often hide behind this everyday term. My goal is not to replace an in-person consultation, but to help you navigate the topic and understand what truly deserves attention. This will help you better understand the situation and make a timely and informed decision about the next steps.
What Is an Abdominal Hernia
The term “abdominal hernia” most often refers to the appearance of a bulge or a painful area on the anterior abdominal wall that becomes more noticeable during physical exertion, coughing, or straining. For patients, this is a clear and understandable sign, which is why this name has become established in everyday use and search queries. However, behind this seemingly simple description lies a very specific anatomical process. In practice, conversations with a surgeon most often begin with exactly this kind of description.
From a surgeon’s perspective, a hernia is not a “tumor” or a neoplasm. It refers to the protrusion of internal tissues or organs beyond the muscular and tendinous framework of the abdomen through a weakened area. Simply put, it is a situation where the natural “protection” of the abdominal wall can no longer withstand the load. To properly assess the situation, it is important to agree on terminology from the outset.
Why the Term “Abdominal Hernia” Is Used in Everyday Language
In everyday life, it is not so important for a person to know through which exact anatomical zone the protrusion occurs. They see or feel a problem in the abdominal area – hence the generalized name. This approach is understandable and natural: the symptoms feel similar, and medical details are usually unknown at this stage. For patients, it is more important to understand what is happening to their body than to know the precise anatomical term.
In addition, different types of hernias can present in similar ways. That is why the same patient may initially speak about an “abdominal hernia” and, after consultation, learn the more precise name of their condition. This is a normal path – from a general sense of a problem to a specific diagnosis.
Does Such a Diagnosis Exist in Medicine
In medical classification, there is no diagnosis called “abdominal hernia.” Physicians use more specific terms that indicate the location of the hernia – inguinal, umbilical, linea alba hernia, postoperative hernia, and others. This is important not formally, but practically: risks, observation strategy, and treatment approach depend on the type of hernia. In practice, it is not uncommon for clarifying the hernia type to change further recommendations.
At the same time, using the everyday term is not a mistake. The physician’s task is not to correct the patient, but to understand what is bothering them and translate that description into medical language. What matters here is not the word itself, but an accurate understanding of the essence of the problem.
Understanding what lies behind the concept of an “abdominal hernia” makes it logical to move on to the next question – why this weakening of the abdominal wall occurs at all and what processes lead to it.
How an Anterior Abdominal Wall Hernia Forms
A hernia does not develop “in one day.” More often, it is a gradual process in which a weak area appears in the abdominal wall and, under the influence of load, a protrusion then forms. It is important to understand the mechanism, because it explains the causes, the symptoms, and why a hernia usually progresses over time. During consultations, it is often necessary to explain that the absence of sharp pain does not mean the process has started recently.
In simple terms, the abdominal wall functions as a strong framework: muscles and tendinous structures keep the internal organs in the correct position. When an area within this framework becomes less able to withstand load, the contents of the abdominal cavity begin to “press” against that spot. This is how a hernial protrusion forms. This mechanism is the same for different types of hernias, with only the location of their appearance differing.
Weakening of Muscles and Connective Tissue
Every person has anatomically more vulnerable zones: where vessels and canals pass, where tendons transition into muscles, or where surgical incisions have previously been made. If tissues in such areas become weaker, they resist internal pressure less effectively. These zones most often become the point where a hernia forms.
Connective tissue is the body’s “reinforcing material.” It forms ligaments, membranes, and tendons and largely determines the strength of the abdominal wall. In some people it is naturally denser and stronger, while in others it is more “pliant.” As a result, two people may lift the same loads, but a hernia will develop in only one of them – simply because their baseline tissue strength is different. In practice, this is one of the reasons patients are surprised and say, “I did the same things as before, yet the hernia still appeared.”
Increased Intra-Abdominal Pressure
There is constant pressure inside the abdomen, and it naturally increases during coughing, straining, lifting heavy objects, and intense physical work. With constipation, a person strains regularly; with lung diseases, prolonged coughing may occur; with weight gain, the load on the abdominal wall increases. By themselves, these situations do not “create” a hernia out of nothing, but they accelerate the formation of a protrusion where a weak spot already exists. Most often, patients recall such factors only after symptoms have appeared.
Therefore, a hernia is better understood as a combination of two factors: there is an area of the abdominal wall that withstands load poorly, and there are regular episodes of increased pressure. When these factors coincide, a hernial protrusion develops over time, and symptoms may then intensify. This explains why limiting physical load alone does not always stop the process.
By understanding this mechanism, it becomes easier to see why in some people a hernia develops after surgery, in others against a background of physical strain, and in still others without an obvious cause. From this understanding, a discussion naturally follows about the reasons that most often lead to weakening of the abdominal wall. Next, it is logical to move on to the most common causes that lead to weakening of the abdominal wall and trigger this process.
Main Causes of an Abdominal Hernia
The mechanism of hernia formation is almost always the same, but the causes that lead to it may differ. In practice, there is rarely a single factor – more often, several circumstances overlap. This is why a hernia may appear in a person without heavy physical labor and, conversely, not develop in someone who has lived with physical strain for years. During consultations, this point most often causes confusion for patients and requires detailed explanation.
Congenital Weakness of the Abdominal Wall
Some people initially have structural features of connective tissue. It may be less dense and less able to withstand load, especially in so-called anatomically weak areas. A person may be unaware of this for a long time until conditions arise in which this weakness becomes noticeable. Up to a certain point, the body successfully compensates for these features.
This feature is not a disease, but it explains why hernias sometimes appear “out of the blue,” without obvious injury or overload. In such cases, external factors only trigger a process that was anatomically predetermined. That is why patients often say they cannot associate the appearance of a hernia with any single event.
Physical Strain and Lifting Heavy Objects
Lifting heavy objects, sudden exertion, and work involving constant tension of the abdominal muscles increase intra-abdominal pressure. If the load is distributed incorrectly or applied regularly, the risk of hernia formation increases. This is especially noticeable with repeated, similar efforts.
It is important to understand that this applies not only to athletic or occupational strain. Unprepared lifting of heavy bags, home repairs, or work in the garden – all of these can become triggering factors, especially when weak areas of the abdominal wall are present. In practice, patients often recall such everyday situations only in hindsight.
Postoperative Changes
After surgical interventions on the abdomen, the abdominal wall is no longer anatomically “intact.” Even with careful suturing of tissues, a scar differs in strength from unaffected structures. If healing is not ideal or physical strain resumes too early, a postoperative hernia may form in the area of the scar. Sometimes it appears a considerable time after surgery, when the connection to the intervention no longer seems obvious.
Such hernias require special attention, because their behavior and treatment approaches differ from those of primary hernias. Assessing the condition of the scar and surrounding tissues is of fundamental importance here.
Age-Related and Metabolic Factors
With age, tissues lose elasticity and strength. Additional roles are played by body weight fluctuations, chronic diseases, and metabolic disorders. All of this affects the condition of muscles and connective tissue, making the abdominal wall less resistant to load. These changes occur gradually and often remain unnoticed by the person.
Against this background, even routine activities that previously caused no problems may lead to the appearance of a hernia or its enlargement. That is why age itself cannot be considered a cause, but its influence should not be ignored.
The causes of hernia formation help explain why it develops, but for patients, something else is usually more important – how it manifests and which signs should be paid attention to first. Knowing the causes without understanding the symptoms rarely helps to suspect the problem in time. That is exactly what we will discuss next.
Symptoms of an Abdominal Hernia
The manifestations of a hernia can vary – from barely noticeable discomfort to pronounced pain. In the early stages, many people do not attach importance to symptoms, attributing them to fatigue or overexertion. However, it is precisely the early signs that make it possible to suspect a problem and consult a physician before complications develop. In practice, it is often said that a person “simply did not pay attention” to the initial manifestations.
It is important to understand that the intensity of symptoms is not always directly related to the size of the hernia. A small protrusion can sometimes cause more discomfort than a larger one, and vice versa. This often comes as a surprise to patients and requires separate explanation during consultation.
Bulging in the Abdominal Area
The most characteristic sign of a hernia is the appearance of a bulge under the skin. It may be visible constantly or appear only during straining, coughing, or lifting heavy objects. When lying down, such a bulge often decreases or disappears. This feature most often makes a person suspect that it is not just muscular discomfort.
On palpation, the bulge is usually soft, sometimes with a sensation of “rolling.” Over time, it may become more pronounced, especially if the hernia has existed for a long period. At this stage, many patients begin to notice that the bulge appears more frequently and with less exertion.
Pain and Discomfort During Physical Activity
Pain associated with a hernia is most often pulling or aching in nature. It intensifies with physical activity, prolonged standing, bending, coughing, or straining. After rest, unpleasant sensations usually decrease or resolve. Many people perceive such pain as “muscle overload,” especially in the early stages.
In some patients, pain does not appear immediately but develops as the hernia increases in size. This is one of the signs that the load on the weakened area of the abdominal wall is increasing. From a surgeon’s perspective, the onset of pain is a signal that the compensatory capacity of the tissues is beginning to be exhausted.
Changes in Symptoms When Lying Down
A characteristic feature of a hernia is a change in sensations when body position changes. In a horizontal position, pressure within the abdominal cavity decreases, and the protrusion may become smaller or disappear completely. At the same time, pain and the feeling of tension lessen. This sign often helps distinguish a hernia from other causes of abdominal pain.
This kind of “variability” of symptoms often differentiates a hernia from other abdominal conditions and helps the physician suspect the correct diagnosis already at the examination stage. In clinical practice, this is one of the key reference points during the initial assessment.
The severity of symptoms largely depends on which specific hernia has formed and where it is located. Therefore, similar complaints in different people may have different underlying causes. The next step is to understand which types of hernias most often lie behind the generalized concept of an “abdominal hernia.”
Which Types of Hernias Are Commonly Called an “Abdominal Hernia”
When a patient speaks about an “abdominal hernia,” they most often describe an external sign – a protrusion or discomfort in the area of the anterior abdominal wall. However, from a medical perspective, such manifestations may be associated with different types of hernias. The distinction between them is important not only for formulating a diagnosis, but also for understanding potential risks and treatment approaches. In practice, clarifying the type of hernia is what allows the discussion to move from general considerations to specific decisions.
Below are the most common types of hernias that are most often grouped under one general name in everyday language. This list is not an academic classification, but rather reflects the situations patients most frequently present with during consultations.
Inguinal Hernia
An inguinal hernia forms in the area of the inguinal canal. It occurs more often in men, but can also develop in women. The protrusion usually appears in the groin, may increase with physical strain, and decrease when lying down. Sometimes patients note discomfort or pulling sensations without immediately associating them with a hernia.
This type of hernia is well studied and is among the most common. At the same time, inguinal hernias differ in structure and behavior, which is always taken into account when choosing a treatment strategy. In clinical practice, even hernias with outwardly similar manifestations may require different approaches.
Umbilical Hernia
An umbilical hernia develops in the area of the navel – a location that is anatomically more vulnerable. In adults, it is often associated with increased load on the abdominal wall, changes in body weight, or pregnancy. Patients frequently notice the cosmetic defect first, without suspecting the possible risks.
In the early stages, an umbilical hernia may cause only minor discomfort, but over time the protrusion usually increases. It is precisely the gradual progression of changes that often leads to delayed consultation.
Linea Alba Hernia
The linea alba is a tendinous structure along the midline of the abdomen. When it weakens, hernias may form that present as protrusions above or below the navel. Such hernias are not always clearly visible externally, especially in the early stages.
These hernias are often accompanied by painful sensations, especially when the abdominal muscles are strained. Sometimes patients do not associate these symptoms with a hernia for a long time, considering them manifestations of stomach or spinal problems. During consultations, this is one of the reasons for diagnostic difficulties.
Postoperative Hernia
Postoperative hernias develop in the area of a previously performed surgical incision. Even a well-formed scar remains a weaker area compared to intact tissues. This is because scar tissue differs in structure from normal abdominal wall tissues.
The peculiarity of such hernias is that they may appear months or even years after surgery. Their course and treatment approaches have specific nuances and therefore require separate evaluation. In practice, it is often necessary to explain this delayed connection with a previous intervention to patients.
Understanding which specific hernias lie behind the generalized term “abdominal hernia” makes it possible to realistically assess the situation. The type of hernia largely determines not only the choice of treatment, but also the potential risks if observation is lacking. The next important question that usually concerns patients is what dangers a hernia may pose if it is left untreated for a long time.
Why an Abdominal Hernia Is Dangerous Without Treatment
A hernia is one of those conditions that rarely resolves on its own. If a weak area in the abdominal wall has already formed, it usually increases over time. Therefore, the question is not whether the hernia will cause inconvenience, but when and in what form it will begin to create serious problems. In clinical practice, the issue is almost always progression rather than stabilization of the process.
The danger of a hernia does not always manifest immediately. This is precisely why many patients delay seeing a physician for a long time, relying only on their current sensations. During consultation, it often turns out that the hernia has existed for several years and simply did not attract attention earlier.
Gradual Enlargement of the Hernial Protrusion
Over time, the hernial opening widens and the protrusion becomes more noticeable. What previously appeared only during physical strain may begin to cause discomfort even at rest. Enlargement of the hernia complicates subsequent treatment and limits the choice of surgical techniques. The larger the hernia, the more difficult it becomes to restore the normal anatomy of the abdominal wall.
In addition, as the hernia grows, the surrounding tissues are increasingly stretched, which affects the appearance of the abdomen and overall well-being. This aspect is often underestimated, although it is directly related to the further course of the condition.
Limitation of Physical Activity
Even in the absence of pronounced pain, a hernia gradually begins to “remind” a person of its presence. People avoid sudden movements, lifting heavy objects, physical work, and sometimes even ordinary activities. A constant feeling of vulnerability and tension arises in the affected area. Over time, many begin to intuitively “protect” this area, changing their habitual lifestyle.
With time, this affects not only physical condition, but also overall quality of life. Clinical experience shows that such limitations accumulate gradually and often go unnoticed by the patient.
Risk of Hernia Incarceration
The most serious complication of a hernia is incarceration. This is a situation in which the contents of the hernial sac are suddenly compressed within a narrow opening. In such cases, severe pain occurs, the protrusion becomes firm and painful, and the general condition may deteriorate rapidly. It is important to understand that predicting the moment of incarceration in advance is impossible.
In my clinical experience, the most common mistake is to rely only on the current level of pain. Incarceration can occur even with a hernia that appears calm, so a sensible approach is to have the situation assessed by a surgeon at least once and to understand your individual level of risk.
Incarceration requires urgent medical care and emergency surgical intervention. This risk is the main reason why hernias should not be left unattended. In practice, incarceration often develops in the setting of a seemingly “calm” hernia that caused little or no discomfort for a long time.
Understanding the possible complications helps to view the problem differently. Knowing these risks makes it easier to determine the moment when delaying a visit to the physician is no longer reasonable. Therefore, the next logical question is when it is necessary to seek medical attention and not postpone consultation.
When It Is Necessary to See a Doctor
A hernia does not always require urgent intervention, but it always requires evaluation by a specialist. The main task at this stage is to understand exactly what we are dealing with, what the risk of complications is, and which strategy will be the most reasonable in a particular situation. Relying solely on personal sensations in the case of a hernia is not always safe. Even with similar complaints, the clinical situation may differ significantly.
There are several signs in which the appearance of a surgeon’s consultation should not be postponed.
If the Protrusion Is Increasing
An increase in the hernial protrusion indicates that the weak area of the abdominal wall is expanding. Even if there is no pain, the very fact of enlargement indicates progression of the process. The larger the hernia becomes, the more complex its subsequent treatment and the greater the load on the surrounding tissues. The physician evaluates not only the size, but also the dynamics of changes.
If Pain or a Feeling of Tension Appears
The appearance of pain, a feeling of pressure, or constant tension in the area of the hernia is a signal that the tissues are experiencing increased load. Pain may be moderate and occur only with movement, but over time such sensations usually intensify. At this stage, it is important not to wait for pronounced symptoms.
Even mild but regular pain sensations are a reason for examination, not for “watchful waiting.” Early assessment helps avoid unjustified limitations and guesswork.
If the Hernia Stops Being Reducible
One of the warning signs is a situation in which a previously reducible protrusion no longer decreases when lying down or with gentle pressure. This may indicate changes in the area of the hernial opening and an increased risk of complications. Such a change in hernia behavior requires professional evaluation.
In such cases, postponing a visit to a physician is particularly undesirable, even if overall well-being remains satisfactory. Timely consultation in this situation allows the issue to be addressed calmly rather than acting in haste.
Understanding when consultation is needed logically leads to the next question – how exactly a physician confirms the presence of a hernia and which diagnostic methods are used in practice.
How Hernia Diagnosis Is Performed
Diagnosis of a hernia usually does not require complex or multi-stage examinations. In most cases, already at the initial appointment the surgeon can understand what the patient’s discomfort is related to. At the same time, the physician’s task is not simply to confirm the presence of a hernia, but to assess its type, size, and potential risks. It is this assessment, rather than a single formal conclusion, that determines the subsequent strategy.
The examination always begins with simple and understandable steps.
Surgeon’s Examination
The primary method of diagnosing a hernia is a clinical examination. The physician assesses the condition of the abdominal wall at rest and during straining, pays attention to the location and nature of the protrusion, its size, and its behavior in different body positions. Such an examination allows key information about the condition of the abdominal wall to be obtained immediately.
During the examination, the surgeon also clarifies complaints, the duration of symptoms, and the conditions under which they intensify or decrease. This information is often no less important than the objective findings themselves. In practice, it is precisely the combination of examination and complaints that provides the most accurate picture of the situation.
Ultrasound of the Anterior Abdominal Wall
Ultrasound examination is used in cases where details need to be уточнити. Ultrasound helps determine the contents of the hernial sac, the size of the hernial defect, and the condition of surrounding tissues. This is especially useful when external manifestations are mild or have an atypical presentation.
The method is safe, does not require complex preparation, and complements examination findings, especially in small or atypically located hernias. At the same time, ultrasound is considered an adjunct to examination rather than a replacement.
After the diagnosis is clarified, the next logical question usually arises – what to do next and which treatment options exist. Understanding the extent and characteristics of the hernia makes it possible to discuss further steps specifically and without unnecessary assumptions. The next section is devoted to this topic.
Main Approaches to Hernia Treatment
After the diagnosis is confirmed, patients naturally have questions about treatment. Here it is important to set the emphasis right away: the choice of strategy always depends on the type of hernia, its size, symptoms, and the person’s overall condition. There is no universal solution suitable for everyone, which is why individual assessment is so important. Even with a similar diagnosis, recommendations may differ.
At the same time, there are basic principles worth knowing in advance.
Why Conservative Treatment Does Not Eliminate a Hernia
Conservative treatment usually refers to wearing a support band, limiting physical load, and modifying lifestyle. These measures may temporarily reduce discomfort, but they do not eliminate the root cause of the hernia – a defect of the abdominal wall. This is a fundamental point that often causes misunderstanding.
From a clinical standpoint, it is important to state this directly: a supportive belt and activity restrictions may reduce discomfort, but they do not close the tissue defect. Once a hernia has formed, it cannot be “cured without surgery” – symptoms can only be managed temporarily while choosing the appropriate timing for intervention.
A band only supports tissues externally and may be used as a temporary measure, for example during preparation for surgery or when contraindications are present. However, one should not expect the hernia to “resolve” or disappear without intervention. A weakened area of the abdominal wall does not restore itself. In practice, a band is considered a supportive, not a curative, method.
Surgical Treatment as the Main Method
At present, the only way to prevent progression of a hernia and the risk of complications is surgical treatment. The essence of the operation is elimination of the hernial defect and reinforcement of the weakened area of the abdominal wall. The goal of the intervention is not merely to remove the protrusion, but to restore normal anatomy.
Modern surgery offers various techniques that are selected individually. The goal is always the same – to restore anatomy and reduce the likelihood of hernia recurrence. Decisions regarding timing and extent of the intervention are made after an in-person consultation and examination. It is at this stage that all possible options are discussed, rather than a template decision being applied.
Understanding treatment approaches helps alleviate many concerns, but patients still have specific questions that they ask most often. These questions arise regardless of age and type of hernia. Below, I will address the most common ones.
Frequently Asked Questions About Abdominal Hernia
Even after detailed explanations, patients still have questions. This is normal. A hernia is a topic directly related to a person’s sense of bodily safety, so doubts and concerns are natural. Below, I answer the questions I hear most often during consultations. As a rule, they arise regardless of age or type of hernia.
Is It Possible to Live With a Hernia Without Surgery
It is possible to live with a hernia, but it is important to understand that this refers to observation, not treatment. A hernia does not disappear on its own and, over time, usually increases in size. The question is only how fast this process occurs and what the risk of complications is. These are the factors a physician evaluates first.
In certain situations, a physician may recommend postponing surgery, but such a decision is always made individually and under specialist supervision. This is not a refusal of treatment, but a choice of the optimal moment.
Is an Abdominal Hernia Dangerous
The potential danger of a hernia lies in the risk of incarceration. It is impossible to predict in advance when this may occur. In some patients, a hernia remains calm for years, while in others a complication develops unexpectedly. This is one of the reasons why observation without medical consultation cannot be considered a safe strategy.
For this reason, a hernia is not regarded as a harmless condition, even if it currently causes little or no discomfort.
Does a Support Band Help With a Hernia
A support band does not treat a hernia. It may temporarily reduce discomfort and decrease load on the abdominal wall, but the tissue defect remains. A band may be used on a physician’s recommendation as a supportive or temporary measure. Most often, its use is limited to specific situations.
Relying on a band as an alternative to treatment is not advisable.
Can a Hernia Disappear on Its Own
No. A weakened area of the abdominal wall does not restore itself. Even if symptoms temporarily decrease, the hernia itself does not disappear. Absence of pain does not mean the problem has been resolved. This is one of the most common myths encountered by surgeons.
What Happens if a Hernia Is Not Treated
Without treatment, a hernia usually enlarges, discomfort increases, and the risk of incarceration rises. In addition, treatment may become more complex over time than in the early stages. That is why delaying intervention is rarely justified.
Is Surgery Always Required
Surgery is not required immediately in all cases, but it is the only way to eliminate a hernia. The question is not so much whether surgery is needed at all, but when and under what conditions it is best performed. This decision is made individually.
The answer to this question can be given only after an in-person assessment of the situation.
Understanding the answers to these questions helps form a general view of the problem. However, final conclusions are always made with consideration of the specific case and the patient’s condition. That is why there are no universal recommendations in this context.
Physician Consultation for an Abdominal Hernia
Even with similar symptoms, hernias can differ significantly in type, size, and risk profile. What may be acceptable for one patient in an observational approach may require a more active strategy for another. That is why universal recommendations do not exist here. Medical assessment always begins with understanding the specific situation rather than applying ready-made solutions.
A consultation with a surgeon makes it possible to accurately determine the type of hernia, assess the condition of the abdominal wall, and discuss optimal next steps. This is not a commitment to surgery, but an opportunity to calmly and without haste understand the situation, receive clear answers, and make a balanced decision. In many cases, it is precisely after such a discussion that the main anxiety related to uncertainty subsides.
If there is doubt, discomfort, or a protrusion in the abdominal area, it is always best to start with a specialist consultation. This is the first and most logical step in the medical pathway for a hernia.
Clinical Guidelines and References
- European Hernia Society (EHS). Midline Incisional Hernia Guidelines. European Hernia Society, 2023.
- Henriksen N.A. et al. EHS and AHS Guidelines for Treatment of Primary Ventral Hernias (Umbilical and Epigastric Hernias) in Special Circumstances. BJS Open, 2020.
- Muysoms F.E. et al. European Hernia Society Guidelines on the Closure of Abdominal Wall Incisions. Hernia, 2015.
- Deerenberg E.B. et al. Updated Guideline for Closure of Abdominal Wall Incisions from the European and American Hernia Societies. 2022.
- International Endohernia Society (IEHS). Update of Guidelines for Laparoscopic Treatment of Ventral and Incisional Abdominal Wall Hernias (Part A). Surgical Endoscopy, 2019.
