Complex Hernia Repair and Abdominal Wall Reconstruction
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Complex Hernias and Abdominal Wall Reconstruction
Large or complicated abdominal wall hernias can be difficult to treat. Abdominal wall reconstruction is a specialized surgery that repairs and strengthens the abdominal wall in people with large or complex hernias. If these hernias are not repaired correctly, they can come back or cause other health problems. Our surgeons use advanced and minimally invasive techniques whenever possible to repair complex hernias and rebuild the abdominal wall.
What Is a Complex Hernia?
A hernia happens when there is a hole or weak spot in the abdominal wall, allowing tissue or organs to push through.
A complex hernia often develops in an area where a person has had previous surgery or a hernia repair. The repair can be even more difficult if there is a fistula (an abnormal connection between organs or tissues) or if surgical mesh has been used before.
You may need a surgeon who specializes in complex hernia repair if you have:
- A hernia larger than 8 centimeters
- One or more previous hernia repairs, especially if they failed
- Significant loss of abdominal wall strength or support
- A fistula or a history of mesh infection
- A body mass index (BMI) over 35
- Medical conditions such as diabetes or obesity, or if you smoke
- A history of open abdominal surgery
What Causes Complex Hernias?
Complex hernias can develop for several reasons, including:
- Previous open abdominal surgery
- Heavy lifting
- Weak abdominal muscles or tissues
- Obesity
- Smoking
- Long-term coughing or sneezing, including from COPD
- Long-term steroid use
Complex hernias may also occur in people who have had previous hernia repairs or abdominal injuries.
Many people with complex hernias develop a noticeable bulge or change in the shape of their abdomen. While these hernias are usually not life-threatening, they can be painful, uncomfortable, and affect daily life. Hernias do not heal on their own. Without surgery, they usually become larger and harder to repair over time.
Preparing for Surgery
At your first appointment, a hernia specialist will review your medical history and discuss treatment options. Most patients will need a CT scan before surgery planning.
To improve your results and lower the chance of the hernia returning, we may recommend:
- Quitting smoking
- Weight loss
- Improving nutrition, especially protein intake
- Managing diabetes
- Treating heart or lung conditions
Depending on your health needs, you may also need additional tests, imaging, lab work, or consultations with other specialists. We will create a personalized treatment plan designed to give you the best possible outcome.
What to Expect During Surgery
Abdominal wall reconstruction can be performed using:
- Minimally invasive techniques
- Robotic-assisted surgery
- Traditional open surgery
The best approach depends on the size and complexity of your hernia.
The procedure is done under general anesthesia. It often involves repairing and repositioning abdominal muscles and tissues and placing surgical mesh to strengthen the repair.
Surgery may take anywhere from 2 to 5 hours or longer, depending on factors such as:
- Your age
- Other medical conditions
- The size of your hernia
- Previous surgeries and related complications
Some patients go home the same day, while others may need to stay in the hospital for one or more nights.
Recovery
Most patients return to normal daily activities within 2 to 5 weeks. Regular exercise can usually be resumed about 6 weeks after surgery.
During recovery, you should:
- Avoid heavy lifting
- Avoid strenuous activities
- Follow your surgeon's instructions for gradually returning to normal activities
If surgical drains are placed during the procedure, they will be removed during follow-up visits.
Schedule an Appointment
To make an appointment or request a referral, call 208-302-3200. New patients are typically seen within one week.