Overview

These are hernias, which have occurred though the sutured wounds of previous abdominal operations.  The repair varies with the type and size of the hernia but in general they require wide exposure of good abdominal wall muscle and a large sheet of mesh to reinforce any sutured repair.  With large hernias time in hospital is often 4 or more days and recovery is slow.   Laparoscopic repairs can be performed in some cases inserting the mesh on the inside of the abdominal cavity and hence avoiding the very large incision and tissue dissection.  Recovery is therefore much quicker as the pain is greatly reduced. 

Surgery

The open surgical techniques to repair these types of hernia and the types of mesh have been changing and improving over recent times. With smaller hernias and modern mesh coated expandable patches, it is often possible to have overnight surgery and speedy recovery. My preferred method is to place reinforcing mesh deep to the muscle layer, whenever possible, but still in front of the abdominal lining layer.  This preperitoneal repair is not always technically possible to perform, but where it can be, it leads to a very reduced amount of surgical dissection in the fatty tissue layer in front of the muscle layer. Therefore there is much less post operative pain, and much quicker discharge from hospital and return to full activities.  There is also a reduced risk of the wound and the mesh becoming infected.

Post Operative Instructions

Instructions for recovery are the same as for umbilical hernias.