Care for Complex Hernias

If you suspect you have a hernia, there’s no need to panic, said John Mellinger, MD, and Jim Fullerton, MD, co-medical directors of the Memorial Advanced Hernia Center. Although they won’t go away on their own, most hernias are easily treated. Hernias occur when an organ or tissue bulges through a weak portion of the surrounding muscle, usually in the abdomen or groin, and produce an obvious swelling underneath the skin.

Patients with complex hernias may be referred to the Memorial Advanced Hernia Center. Several factors make a hernia case complex, including size and location. Treatment becomes more challenging if the hernia is associated with a stoma, such as a colostomy incision, or if it has appeared in an area previously treated with radiation. Complex cases also include hernias that have recurred multiple times.

Complex Hernia Diagnosis

For most patients, a simple doctor visit can start the process of hernia treatment. But there are instances when hernia patients should seek immediate care. If you are experiencing sudden, intense pain, nausea or vomiting, or if you’re having difficulty with bowel movements, you may have an incarcerated hernia. An incarcerated hernia has a section of intestine or another organ trapped in it and requires prompt medical attention.

Complex Hernia Treatment

Many hernias are repaired with minimally invasive outpatient surgery. The use of laparoscopy, which requires only a small incision, also reduces the likelihood that a hernia will come back. Previous abdominal surgery is a major risk factor for hernias, and older, more invasive procedures often led to recurrence.

“More and more, we’re moving to laparoscopic repair,” Dr. Fullerton said, noting that patients can often go home the same day and recover completely in a short time. “Those procedures are very safe, with little complication risk.”

Complex hernias can require more extensive surgery, including the use of mesh to repair the abdominal wall. However, mesh isn’t always effective for larger hernias. In recent years, surgeons have pioneered a technique that separates layers of the abdominal wall, allowing them to close defects without relying solely on mesh. Plastic surgery techniques can also be used to move tissue from elsewhere in the body to compromised areas.

Talk to Your Doctor

Even if your hernia doesn’t require advanced care, it’s still important to address the problem with your doctor before more serious problems develop.

“People who neglect them for prolonged periods end up having more challenging hernias to fix,” Dr. Mellinger said.