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Complex Hernia Program

Complex hernia surgery and abdominal wall reconstruction

A hernia happens when fatty tissue or an organ breaks through weakened muscle or tissue in your abdominal wall. Hernias are often caused by increased pressure in the abdomen.

Our Complex Hernia Program has experts to repair the most common hernia types, including inguinal, umbilical and femoral. However, some hernias are more complex and require a surgeon with advanced training.  

Find a complex hernia surgeon near you to schedule a consultation. 

Learn more

What is a complex hernia?

A complex hernia often occurs at the site of a previous hernia repair. Hernia surgeries also become complex if a prior repair left surgical mesh behind or if the mesh created an abnormal connection between two body parts. 

Other factors that can contribute to a complex hernia repair include:

  • an infection in the abdomen or the mesh
  • a skin ulcer
  • a hernia involving an opening between an organ and the outside of the body, such as a colostomy or ileostomy
  • a hernia that’s larger than three inches
  • a hernia that has required numerous prior surgeries
  • a large amount of abdominal content passed through the herniation
  • hernias in difficult locations such as the side/flank, chest wall, back or pelvis
  • hernias involving a connection between the intestine and skin, which is called a fistula

What causes a complex hernia?

Complex hernias are often caused by one or more failed attempts to repair an existing hernia with or without mesh, resulting in a recurring hernia that’s typically larger than the original. However, a complex hernia can occur at any previous surgical location.   

They can also occur if:

  • surgery was difficult
  • an organ was injured, such as the intestine
  • if the hernia occurred at an incision following an unrelated surgery
  • there’s a complication with mesh that was placed 

Who needs complex hernia surgery and abdominal wall reconstruction?

Most hernias should be repaired to prevent serious complications. You may need surgery if your complex hernia damages your abdominal wall, causes pain or other symptoms, or involves other organs. 

You also may need surgery if you have a mesh-related complication, mesh infection or a chronic wound associated with a prior hernia repair. Abdominal wall reconstruction strengthens the weakened muscle to prevent recurring hernias. 

Risk factors for complex hernia

Factors that may put you at risk for a complex hernia include:

  • being overweight or obese
  • smoking or other forms of tobacco use
  • having diabetes
  • using blood-thinning medication
  • frequent heavy lifting
  • straining due to chronic diarrhea or constipation
  • chronic coughing, sneezing or COPD
  • previous hernia repair surgery or other open surgery

Comprehensive care from a multispecialty team

The Allina Health Complex Hernia Program gives you a multidisciplinary team that’s focused on your goals.

Your care team may include a:

  • surgeon with advanced training and extensive experience in complex hernia repair
  • physician assistant
  • nurse navigator
  • physical therapist
  • occupational therapist
  • smoking cessation specialist to help you avoid tobacco-related complications
  • weight management team to help with weight-loss strategies to decrease pressure on your abdominal muscles and help to improve the success of surgery

Our program also includes:

  • technology for minimally invasive and robotic surgical techniques
  • data collection and reporting that enables us to manage, track and improve hernia surgery at Allina Health
  • monthly multidisciplinary conferences for our surgeons to receive ongoing training in complex hernia repair and to review complex cases as a team
  • peer-reviewed research studies that advance the field of hernia surgery
  • participation in clinical trials for new hernia-related mesh and other technology

Types of complex hernia and abdominal wall reconstruction surgery

The type of hernia surgery you have will depend on the size and complexity of your hernia, as well as your age, overall health status, and any prior surgical complications. The surgery takes one to six hours to complete, depending on the type of hernia and other circumstances unique to you.

While most complex hernia surgeries are open procedures, you may be a candidate for laparoscopic or robotic surgery.

Preparing for complex hernia and abdominal wall reconstruction surgery

Before complex hernia surgery, focus on quitting tobacco, maintaining a healthy weight and managing diabetes to ensure the best possible outcome.

  • Quit smoking. Don’t use tobacco for at least 12 hours before surgery. Smoking and tobacco use can increase your risk of heart and lung problems, infection and blood clots during and after your surgery.
  • Maintain a healthy weight. If you’re overweight, consider a weight-management program to reduce your risk of complications after surgery.
  • Manage diabetes. If you have diabetes, maintain a healthy glucose level before surgery. Your surgeon may postpone surgery if your blood sugar levels are too high. 

Complex hernia surgery recovery

Recovery time varies from person to person. You may stay in the hospital for one or more days after the surgery. Most people return to normal activities within two to five weeks after hernia surgery.  You may require one or more types of surgical drains for several days to several weeks after surgery. 

You will receive training for managing those drains at home prior to leaving the hospital.  If you need assistance at home from a visiting nurse, this will be arranged for you before you leave the hospital.

After surgery:

  • Avoid strenuous activity and heavy lifting. Most people can resume their normal exercise routine after about six weeks.
  • Your health care provider will tell you when it’s OK for you to shower, drive, return to work and have sex.  
  • Walk short distances daily. Increase the distance as you’re able.  
  • Alternate periods of rest and activity.  
  • Do not cross your legs while you sit. This helps keep your blood moving (circulating) to prevent blood clots.  
  • Change slowly from a lying or sitting position to a standing position.  
  • Avoid using tobacco and being exposed to secondhand smoke. They can slow your recovery.

Health insurance coverage and costs

Contact your health insurance provider about medical coverage and get a price estimate before scheduling surgery. You’ll pay any deductible amounts and charges your policy doesn’t cover.

First published: 8/1/2022
Last reviewed: 7/25/2022