Definition
A recurrent hernia is a hernia that was repaired in your past that has returned. Recurrent hernias are common, and do not necessarily represent a complication from the original surgery. Mesh (if used) can shrink in size or migrate, and hernia defects can increase in size. Increased risk of developing a recurrent hernia can be seen in those with a history of cigarette or cigar smoking, obesity (body mass index greater than 35), and sometimes genetics. Recurrent hernias are best managed by surgeons devoted to hernia repairs.
Presentation
Recurrent hernias can present as a bulge or pain (or both) in your abdomen.
Next steps for you
If you think you have a recurrent hernia, then make an appointment with a hernia expert to discuss your options. Before making the appointment, try to get your old operative report. This document will describe the technique and product used, and this information is very helpful to your surgeon.
Imaging is useful and your surgeon will likely order a CTSCAN. This can identify the hernia size, contents, and other hernias you may or may not also have.
Repair options are numerous and include:
- open primary repair
- open mesh repair (mesh can be placed inside your abdomen, between the muscle and peritoneum, or as an onlay on top of the fascia layer).
- laparoscopic or robotic mesh repair. Both of these are considered minimally invasive surgery (MIS) repairs. (MIS) repairs can be done with or without defect closure. Mesh can be placed intraabdominal or between the peritoneum and muscle. Suture fixation, tack fixation, or a combination are common. Ask your surgeon about the technique and mesh they prefer for your case.
Some surgical risks include, but are not limited to:
Recurrences, chronic pain, bowel obstruction, enterotomy, mesh erosion, fistula, seroma, hematoma, and infection.
Surgical Preparation
Patients with obesity (BMI greater than 35) should try to lose weight to keep a body mass index less than 35 if possible. this will minimize risk of an additional recurrence.
Patients must quit smoking.
