Recurrent Hernias

A recurrent hernia is when another one occurs in the general area of a previously repaired hernia. A hernia may recur months or even years following surgery, despite the success of most hernia procedures. However, the risk of developing a recurrent hernia is most significant in the first two years after surgery.

What causes recurrent hernias?

There are many reasons for hernia recurrence in patients after successful hernia repairs.

Various conditions, activities, or behaviors that put stress on or weaken the abdominal muscles after the first surgery might also result in recurrent hernias. Some of these conditions interfere with wound healing. These include:

  • Smoking
  • Diabetes
  • Being overweight
  • Chemotherapy, steroids, or other drugs that weaken the immune system
  • Strenuous activities like heavy lifting

Recurrence Rates for Different Types of Hernias

With proper care, the majority of hernias have favorable outcomes. A recurrence of an inguinal hernia is uncommon (1 to 3 percent chance, depending on the type of hernia and many other factors). Incisional hernias are more prone to recur.

After an incisional hernia repair, the likelihood of recurrence varies depending on the patient. Risk factors such as obesity and other health conditions can increase the risk of recurrence. In addition, the size of the initial hernia defect (larger hernias are more likely to recur), whether the hernia has already been repaired (recurrent hernias are more likely to recur when repaired again), and other factors (surgical technique, the type of a patient’s tissue, etc.) are all factors that impact whether a hernia is likely to reoccur.

One to three percent of groin hernias recur, compared to five to ten percent for abdominal (ventral) hernias and ten to fifteen percent for stoma hernias. The recurrence rate for the most difficult hernias ranges from 10 to 20 percent, depending on the kind of hernia and other variables.

If you’ve wondered if you can keep your hernia from reoccurring, read that article for practical steps.

Why choose the Iskandar Complex Hernia Center for your Recurrent Hernia?

You deserve access to a world-class abdominal expert who is always accessible and committed to helping patients improve their quality of life. The Iskandar Complicated Hernia Clinic is a complex hernia and advanced abdominal surgery center devoted to significantly improving patients’ lives and giving them freedom from debilitating hernias.

In this day and age, renowned experts who genuinely care about their patients can be hard to come by. However, you can be sure that you will get compassionate care if you choose The Iskandar Complex Hernia Center to help with your recurrent hernia.

We can help with recurrent hernias
because we treat the whole person.

More FAQ’s about Recurrent Hernias

Are recurrent hernias and complex hernias the same thing?

A hernia develops when tissue or a portion of an organ protrudes through the abdominal wall. Hernias that return after being repaired are referred to as recurrent hernias. Factors that lead to hernia being labeled as complex include the size of the hernia, recurrent hernias, history of infections, presence of stomas (ileostomy, colostomy, ileal conduit…), presence of conditions like obesity, diabetes, immunosuppression, and smoking.

At the Iskandar Complex Hernia Center, we ensure that all risk factors are addressed before surgery to minimize the risk and improve outcomes, in addition to performing the best technically possible operation. Preoperative preparation may include better blood glucose control, weight management, smoking cessation, physical therapy, and nutritional optimization.

What is the recurrence rate of robotic/laparoscopic inguinal hernia repair with surgical mesh?

The inguinal hernia recurrence rate is 1–3% in patients treated with a robotic or laparoscopic approach with mesh. In addition, patients report having less chronic inguinal pain and a faster recovery after robotic/laparoscopic hernia repair.

What is the recurrence rate of traditional inguinal hernia repair in children?

Pediatric inguinal hernias that recur are very uncommon. The recurrence rates range from 0.3 to 1.2 percent. Recurrence often shows up six months following the first repair. According to recent data, recurrence rates for open and laparoscopic repair are comparable. However, only a small percentage of experienced pediatric surgeons conduct laparoscopic repairs; most pediatric surgeons choose open surgery, not the least because of the assumed decreased recurrence risk.

Most hernia recurrences after repair of an indirect hernia (97%) are indirect, although, in rare circumstances, the recurrence turns out to be a previously undetected direct or femoral hernia. An open or laparoscopic method might be used to fix a recurring inguinal hernia. The nature of the recurring hernia may be determined via laparoscopy, and an urgent repair can be made using either a laparoscopic or open approach. In the hands of an expert, innovative laparoscopic procedures may be successful.

What does component separation mean with regard to recurrence?

Many individuals have large or complicated abdominal wall abnormalities, such as enormous abdominal wall hernias or enterocuteaneous fistulas. Component separation is one approach that may help with the management of these challenging hernias. When doing a traditional hernia repair where there is an inadequate muscle wall that can be pulled back together, a component separation is used. Component separation entails separating and advancing certain layers of the abdominal wall muscle to get the right and left-sided muscles closer to the mid-line for adequate closure. With this procedure, the abdominal wall’s structural and functional integrity and cosmetic appearance are all restored.

Giant abdominal wall hernias are typically repaired using a combination of mesh repair and component separation. It is better to leave component separation to experienced surgeons since it is a complicated surgery.

What is the relationship between recurrent hernias and scar tissue?

Whenever a surgical incision is made, or a hernia repair is performed, our body heals by forming scar tissue rather than regenerating new muscle tissue. Unfortunately, scar tissue is weaker than our native muscle tissues. Also, scarring can make recurrent hernias more complicated to repair compared to initial hernia surgeries as the tissues and organs may be more stuck to each other, increasing the risk of injuries. Therefore, when it comes to repairing recurrent hernias, specialized hernia surgeons are better equipped to treat these hernias.

What are the symptoms of a recurrent hernia?

Some signs and symptoms may include:

  • A bulge at or close to the hernia’s initial location
  • Pain, particularly while coughing, sneezing, or carrying heavy things. Pain may vary from a subtle ache to severe pain.
  • Constipation or bloating.

We’re Here for You

Most hernia repair surgeries are successful when performed by experienced hernia specialists. The Iskandar Complex Hernia Center is an expert in hernia repair surgery and will discuss your medical and surgical history with you prior to your initial repair. Call our office to schedule your consultation, and our friendly team will be happy to assist you.

Posted on August 15, 2022

Posted in hernia surgeryTagged , ,
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Dr. Iskandar, MD, FACS is a board-certified general surgeon with fellowship training in minimally invasive surgery and bariatric surgery. He is an accredited Surgeons of Excellence in Hernia Surgery by the SRC. The Iskandar Complex Hernia Center is one of only two North Texas Hernia Centers deemed Centers of Excellence. As a globally respected complex hernia expert, he specializes in complex hernia repair and abdominal reconstruction. He is also an Associate Professor of Surgery at Texas A&M School of Medicine.