Complex Hernia Repair and Abdominal Wall Reconstruction

Complex hernia repair and abdominal wall reconstruction are problems commonly encountered by the general surgeon and the plastic and reconstructive surgeon.

Often patients will have had multiple abdominal operations in the past as well as possible previous hernia repairs. One of the most important aspects of successful hernia repair is wide exposure and visualization of all strong fascial edges.

Adequate exposure of all hernias and fascial edges can be gained through the lower abdominal incision.  Any redundant skin and or fat that would contribute to a pannus or would be devitalized by the exposure can be excised and discarded. In addition, this helps to eliminate dead space and prevent seroma formation.

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Hernia Repair and Abdominal Wall Reconstruction.

Patients can often present with multiple abdominal hernias from previous surgery or previous hernia repairs. It is often best to expose all of the hernias from the same incision and repair each hernia from the same exposure.

 

The abdominal domain can be tightened where necessary or relaxed where appropriate with component separation to allow an appropriate tension repair. Redundant skin than contains scars from previous operations that would not provide stable soft tissue coverage over the hernia repair can be excised.



 

 

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