Abdominal Wall Reconstruction
Some hernias are too large, or have recurred too often, for a straightforward mesh repair. Abdominal wall reconstruction rebuilds the wall itself, restoring the muscle layers to their proper position and reinforcing them. It is a bigger operation than a standard hernia repair, and it is the right one when the simpler option has already failed.
- For large and recurrent hernias
- Muscle layers restored, not just patched
- CT planning before surgery
- Intensive care available afterwards
Stay
3 to 7 days
Duration
2 to 4 hours
Anaesthesia
General
About Abdominal Wall Reconstruction
A large incisional hernia is not just a hole. The muscles have retracted sideways, the abdominal contents have moved, and simply covering the gap with mesh under tension tends to fail. Reconstruction releases and repositions the muscle layers so they meet in the midline again, with mesh placed to reinforce rather than to bridge. Planning is done from a CT scan, and the operation is longer than a routine repair.
- The muscles are repositioned, not just covered
- Mesh reinforces the repair rather than bridging a gap
- Planned from a CT scan of the abdominal wall
- Weight, smoking and diabetes control materially affect the outcome
Before you read on
Everything here is general information about abdominal wall reconstruction. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest abdominal wall reconstruction.
- Large incisional hernia after previous surgery
- Hernia that has recurred after one or more repairs
- Loss of abdominal wall from injury or infection
- Multiple defects in the abdominal wall
- Hernia with skin or wound problems overlying it
Procedure details
The usual sequence, from first consultation through to follow-up.
Assessment and planning
A CT scan maps the defect and the muscle layers. Weight, smoking and diabetes control are addressed before surgery, because they change the result.
Releasing the layers
The muscle layers are separated and released so they can be brought back to the midline without excessive tension.
Reinforcement
Mesh is positioned to reinforce the repair, in a plane chosen for the type and size of the defect.
Recovery
Drains are usually left for a few days. Mobility starts early and lifting is restricted for several weeks while the repair matures.
How to prepare
What to sort out before you come in.
- Weight loss before surgery genuinely improves the outcome and may be advised
- Stopping smoking is important, as it substantially raises the risk of the repair failing
- Blood sugar control is optimised beforehand in diabetes
- A CT scan of the abdominal wall is arranged for planning
- Arrange substantial help at home for the first few weeks
Recovery
What to expect afterwards, and roughly when.
- Expect three to seven days in hospital
- Drains are usually removed before discharge or shortly after
- An abdominal binder is often advised for support in the early weeks
- No lifting heavier than a few kilograms for six to eight weeks
- Return to physical work takes two to three months
Why choose Humayun for abdominal wall reconstruction
These operations are judged years later on whether the hernia came back, which is decided by planning and by the patient's preparation.
- Planned from CT imaging rather than assessed by examination alone
- Weight, smoking and diabetes addressed before surgery, because they decide the result
- Complex and recurrent hernias taken on rather than referred away
- Intensive care on site for the larger reconstructions
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