Hernia Revision
When we repair a hernia at Hernia Center Los Angeles, we do everything in our power to make sure that your hernia stays repaired. As a result, we have a very low percentage rate of patients who require hernia revision after we have treated them. That said, Hernia recurrence is a risk with any type of hernia repair. Our hernia surgeons frequently treat patients who have experienced hernia treatment elsewhere and are now coming to see us for a successive hernia revision.
- What is Hernia Recurrence?
- What Causes Hernia Recurrence?
- Symptoms of Hernia Recurrence
- How is a Recurrent Hernia Diagnosed?
- Preparing for Hernia Revision Surgery
- How Does Hernia Revision Surgery Work?
- How Long is Recovery After Hernia Revision Surgery?
- Frequently Asked Questions About Hernia Revision
What is Hernia Recurrence?
Hernia recurrence refers to the reappearance of a hernia after a previous hernia repair surgery. A hernia is a condition where an organ or tissue pushes through a weak spot or opening in the surrounding muscle or connective tissue, forming a bulge or protrusion. Hernias can occur in various parts of the body, such as the abdomen, groin, or diaphragm. Despite the initial repair, hernias can sometimes recur, leading to the need for hernia revision surgery.
What Causes Hernia Recurrence?
The key to fixing recurrent hernias is to figure out why the hernia is recurring, and make sure that we fix the actual problem. Usually we will discover one of these causes for the recurrence:
Overlay mesh: In most cases, the initial surgeon used an overlay mesh to repair the hernia. This is simply placing a patch on the hole in the abdominal wall and is much more likely to fail than other techniques for repair.
Infection: In other cases, the patient may have had an infection that prevented the fascia (connective tissue) from closing and healing properly. In this case, it is critical to make sure no infected mesh is still present in the field, and to ensure that the bacteria causing the infection has been eradicated.
Underlying fascia weakness: Another common occurrence requiring hernia revision surgery is that the repair was performed in an area where the fascia is not strong. In most cases involving a fascia weakness, the patient has an unrecognized rectus diastasis. This is a split in the two vertical "six-pack" abdominal muscles, so that there is a gap between them. The whole abdomen will bulge outward in these cases, especially towards the end of the day, and not just in the area of hernia. In this case, the entire muscle split must be repaired when the hernia is repaired, or the hernia repair will be unsuccessful.
Additional risk factors for hernia recurrence include:
- Resuming activity too soon after hernia repair surgery
- Obesity
- Smoking
- Diabetes
- Chronic cough
- Use of steroids
- Chemotherapy1
Symptoms of Hernia Recurrence
Symptoms of a recurrent hernia are often similar to the symptoms a patient experienced with their initial hernia. Hernia recurrence symptoms may include:
- A lump or bulge near or at the site of the original hernia
- Pain or discomfort
- Nausea
- Constipation
- Bloating
How is a Recurrent Hernia Diagnosed?
If you are suspected to be experiencing a recurrent hernia, your doctor will first perform a physical examination of the area. You may also be asked to cough or strain, which could cause the hernia to protrude. A number of imaging tests, such as X-ray, CT scan, or ultrasound, may also be performed.
Preparing for Hernia Revision Surgery
If you have been diagnosed with a recurrent hernia, the first step in preparing for hernia revision surgery is to attend a consultation with a hernia doctor at Hernia Center Los Angeles. Your hernia surgeon will examine your hernia and review your medical history, including documentation from previous hernia surgeries. Your hernia revision treatment plan will be explained to you, and you will have the opportunity to ask questions so that you feel fully educated and prepared for surgery. Once your procedure is scheduled, you will receive detailed pre- and postoperative instructions.
How Does Hernia Revision Surgery Work?
Each recurrent hernia is unique, and the techniques used during hernia revision surgery will depend on the location and type of hernia to be repaired.
The hernia experts at Hernia Center Los Angeles prefer to perform minimal incision, open hernia revision surgery. This is the most effective way to treat a recurrent hernia, and is also less likely to lead to subsequent hernia recurrences.
During hernia revision surgery, an incision is made in the area of the hernia. Next, the hernia is pushed back into place and the area is reinforced with sutures or synthetic mesh. Once the surgeon is satisfied that the hernia has been properly repaired, the incision is closed with staples or stitches.
How Long is Recovery After Hernia Revision Surgery?
Recovery after hernia revision surgery will vary depending on the complexity of the procedure and individual factors. Some patients are able to return home the same day of their procedure, while others may require a hospital stay.
Some pain can be expected after hernia revision surgery, but your surgeon will prescribe pain medication to help you stay comfortable. Your surgeon will also give you instructions about limiting your activity, which may include avoiding heavy lifting and strenuous exercise and refraining from driving.
Frequently Asked Questions About Hernia Revision
Is revision surgery necessary to treat a recurrent hernia?
Yes. The only way to repair a recurrent hernia is through surgery.
Is recurrence more common with certain types of hernias?
Hernia recurrence rates differ according to the type of hernia and the method of repair. Hernia revision surgery is most common for recurrent incisional hernias. Overall, there is roughly a 10% chance of recurrence after hernia repair surgery.2
Is hernia revision surgery outpatient?
For some patients, hernia revision surgery can be performed as an outpatient procedure. For more complex cases, a hospital stay may be necessary.
Contact Us
If you are experiencing hernia recurrence, please contact the experts at Los Angeles Hernia Center to learn more about your hernia revision options.
1 Brigham and Women's Hospital. What is a recurrent hernia? Available: https://www.brighamandwomens.org/surgery/general-and-gastrointestinal-surgery/hernia/recurrent-hernia. Accessed April 17, 2023.2 Cleveland Clinic. Hernia. Available: https://my.clevelandclinic.org/health/diseases/15757-hernia#outlook--prognosis. Accessed April 17, 2023.
