Complex Hernia Repair and Abdominal Wall Reconstruction
Large or complex abdominal wall hernias are a challenging surgical problem. Abdominal wall reconstruction is an advanced surgical procedure that restores the abdominal wall in patients with large, complex hernias. If not fixed properly by expert surgeons, these hernias have a high risk of recurrence and complications. Our surgeons are committed to offering minimally invasive approaches for complex abdominal wall hernia repair and abdominal wall reconstruction.
What is a Complex Hernia?
A hernia is a hole or defect in the abdominal wall. A complex abdominal wall hernia often occurs at the site of a prior hernia repair or surgical incision. The presence of a fistula or prior mesh makes the repair even more complicated. Patients should seek a surgeon with expertise in complex hernia repair if:
- Hernia defect is greater than 8cm
- History of prior hernia repair, multiple failed repairs
- Loss of abdominal domain
- Fistulas, history of mesh infection
- Body mass index (BMI) >35
- High-risk medical conditions including diabetes, obesity and smoking
- History of prior open surgery
What Causes Complex Hernias?
Complex abdominal wall hernias can occur for many reasons, including:
- History of prior open surgery
- Heavy lifting
- Weakness of the abdominal wall tissues
- Obesity
- Smoking
- Long-term coughing or sneezing, COPD
- Steroid use
Who Needs an Abdominal Wall Reconstruction?
Patients who have complex hernias, a history of previously repaired hernias or patients who have suffered trauma to the abdomen. Many patients have large hernias that result in deformity of the abdomen. While rarely life-threatening, these hernias can be very uncomfortable and negatively impact quality of life. They will not go away without surgery, in fact, they only grow larger and more complex over time.
Initial Consultation
Our hernia specialists will review your medical information and discuss repair options at your initial consultation. A pre-operative CT scan is usually needed for this assessment. We will also focus on optimizing and preparing you for surgery so you can achieve the best surgical outcome and lowest risk for recurrence. This may include: smoking cessation, medical weight loss, protein nutrition, diabetes and heart/lung disease management. Additional doctor consultations and labs/imaging may be necessary based on your medical needs. We will provide a personalized approach for your care that will lead to a successful resolution of your hernia problem.
The Procedure
Abdominal wall reconstruction can be performed with both minimally invasive, robotic and open techniques, depending on the complexity of the hernia. These repairs require general anesthetic and typically require reconstruction and repositioning of the abdominal muscles, fascia and insertion of mesh. The operation can be as short as two hours or last five hours or more. This depends on your age, medical conditions, hernia size, complications from prior surgeries and other factors. You may be required to stay at the hospital one or more nights depending on the complexity of your case.
Recovery
Patients typically return to daily activities within two to five weeks and regular exercise about six weeks after the procedure. During recovery, there is no lifting of objects or strenuous activity. Thereafter, a gradual ramp-up of normal activities is started. Any drains placed during the procedure will be removed at follow-up appointments.
Schedule an Appointment
To schedule an appointment or referral, call 208-302-3200. New patients will be seen within one week.