Abdominal Wall Reconstruction & Complex Hernia Repair

Large or complex abdominal wall hernias are a challenging surgical problem. Abdominal wall reconstruction is an advanced surgical procedure that restores the normal function of the abdominal wall. It is recommended for patients with advanced hernias and requires specialized surgical expertise. If not fixed properly, these hernias have a high risk of recurrence and complication.

• What is a Complex Hernia?
• Causes
• Who Needs an Abdominal Wall Reconstruction?
• Initial Consultation
• Procedure
• Recovery
• Meet the Team

What is a Complex Hernia?

A complex hernia often occurs at the site of a prior hernia repair or surgical site. 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
• Loss of abdominal domain
• Fistulas, history of mesh infection
• History of prior hernia repair, multiple failed repairs
• History of prior open surgery
• Body mass index (BMI) >35
• High-risk medical conditions including diabetes, obesity and smoking

What Causes Complex Hernias?

A hernia occurs when an organ pushes through an opening in the abdominal wall or groin. This can happen for many reasons, including:

• History of prior open surgery
• Heavy lifting
• History of chronic diarrhea or constipation
• Obesity
• Smoking
• Long-term coughing or sneezing, COPD

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.

Initial Consultation

Your hernia specialist will review your medical information and discuss repair options at your initial consultation. Smoking cessation, medical/surgical weight loss, nutrition, diabetes and comorbidity management will be addressed if necessary, prior to surgery. Additional doctor consultations and labs/imaging may be necessary based on your medical needs. A personalized approach will be formulated between you and your hernia specialist.

The Procedure

Abdominal wall reconstruction can be performed with both open and minimally invasive 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 the patient’s 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 330.761.9930 or fax 330.761.9936. New patients will be seen within one week. Same-day appointments may be available at our Akron Campus.