Abdominal Wall Hernia Repair

Surgery for complex hernia repair and abdominal wall reconstruction requires advanced expertise and integrated care. Some of the world’s best doctors for plastic surgery hernia repair practice at The Ohio State University Wexner Medical Center’s Center for Abdominal Core Health. See several specialists at once in this convenient hernia center in Columbus, Ohio. We offer plastic surgery hernia repair for abdominal wall hernias and a full range of conditions affecting abdominal strength and overall health.

What is an abdominal wall hernia?

Abdominal wall hernias occur when intestines or tissues push through weak muscle creating a lump under your skin. Complex hernias are hernias that have advanced beyond smaller, more easily treated abdominal wall tears. They often develop after delayed or unsuccessful abdominal hernia surgery. They may be complicated by size, location, infection and risk factors.

Why complex hernia repair is done

Plastic surgery hernia repair may be needed to close abdominal wall tears or treat complex hernias. Complex hernias require more complicated hernia surgery, including abdominal wall reconstruction. 

Reasons for having abdominal hernia surgery include:

• Abdominal wall tears or holes 
• Infected tissues near a hernia 
• Injury to abdominal tissues 
• Prior abdominal surgery   
• Traumatic injury  
• Weak abdominal muscles 
• Pregnancy-related conditions

Symptoms of abdominal hernia

Hernia symptoms vary depending on the location, severity and type of hernia. Signs of a hernia may include:

• Abdominal pain, discomfort or heaviness   
• Bulge in abdomen or groin   
• Constipation 
• Difficulty swallowing 
• Heartburn 
• Nausea and vomiting 
• Pain when standing, bending or lifting 
• Pressure or pain and swelling in or around the groin 
• Sudden pain after heavy lifting or strain

Some hernias do not have symptoms but may be discovered during a physical exam or medical imaging for another condition.

Emergency abdominal hernia symptoms

Complex hernias can cause life-threatening complications if you have strangulated hernia, which traps organs and cuts off blood flow. Call your doctor immediately if you experience the following symptoms:

• Bloating with constipation and/or intermittent diarrhea   
• Fever 
• Nausea and/or vomiting 
• Pain and redness or swelling at hernia site 
• Swollen and tender abdomen

Abdominal hernia risk factors

Complex hernia is common and can occur in people of all ages and conditions. The following conditions can increase your risk of developing a hernia that requires plastic surgery hernia repair: 

• Age 50 or older 
• Birth defects 
• Cancer  
• Constipation or straining 
• Chronic coughing 
• Improperly lifting heavy objects 
• Infection 
• Muscle weakness 
• Obesity  
• Pregnancy-related conditions 
• Prior abdominal surgery 
• Smoking and unhealthy lifestyle habits 
• Strain or stress-related injury 
• Traumatic injury 
• Abdominal muscles weakened by cancer or other conditions

Types of hernias

Abdominal hernias usually appear as a protruding lump in your belly or groin, but not all hernias are visible. Types of hernia include:

• Inguinal (groin) hernias: Inguinal hernias occur at the top of your thigh on one side of your abdomen and are more common in boys and men. 
• Femoral hernias: These hernias occur near the upper part of your inner thigh by the groin. They’re more common in women and can be difficult to push back in. 
• Hiatal (paraesophageal) hernias: Hiatal hernias develop when your stomach slides up and out of your abdominal cavity into the chest cavity. Common symptoms include heartburn, reflux and/or chest pain. 
• Umbilical hernias: These are present at birth, often appearing as a protruding belly button. Umbilical hernias frequently require repair later in life or after pregnancy. 
• Incisional hernias: Damage to the abdominal wall after abdominal surgeries can weaken the muscle, enabling a hernia to form. Incisional hernias can be recurring, complex hernias. They’re called ventral hernias if they’re in the midline of your abdomen. 
• Epigastric hernias: These abdominal hernias often contain fat and may be located in weak areas of the stomach, between your breastbone and belly button. 
• Parastomal hernias: Certain intestinal procedures require an ostomy (surgically created hole) to drain waste. Intestines sometimes push through the weak area around this hole.

Abdominal wall hernia treatment

Ohio State’s plastic surgery hernia care team focuses on hernia repair and abdominal core health. Your abdominal core includes the muscles and structures from side to side and back to back — from your diaphragm to your pelvis.

Treatment usually includes surgery to repair the hole. For more complex hernias, the procedure includes abdominal wall reconstruction. Postoperative rehabilitation and other therapies are also part of treatment at the Ohio State Wexner Medical Center.

Your plastic surgeon will discuss your treatment options. For complex hernias, your doctor may talk about the use of hernia mesh — a strong medical device that reinforces tissue or patches holes in damaged muscles.

The Ohio State Wexner Medical Center surgeons also treat other affected areas, such as the diaphragm, stomach or reproductive organs.

Your surgical team includes your plastic surgeon, general surgeon and additional specialists, depending on your condition. Your plastic surgeon will help determine which specialists may be involved in your care.

How to prepare for abdominal hernia surgery

Before your first hernia surgery consultation, we’ll review your imaging and medical records. You’ll see multiple specialists at one time and place, in our Columbus, Ohio, clinic. We’ll discuss your best treatment options, so you can come in with a problem and walk out with a plan.

Your plastic surgeon will explain everything you need to know about abdominal wall reconstruction. Your doctor coordinates diagnosis and care in collaboration with other doctors at the Ohio State Wexner Medical Center’s Center for Abdominal Core Health.  

Your plastic surgeon and abdominal core health team work with a wide range of specialists across the Ohio State Wexner Medical Center, including those with expertise in areas such as:

• Cancer care  
• General and gastrointestinal surgery 
• Obstetrics and gynecology 
• Urology

What to expect if you have abdominal hernia surgery

Your surgeon is with you before, during and after surgery. Your care team guides you through presurgery steps. You should:

• Schedule an appointment for an initial consultation. 
• Send recent medical records to our office, including provider names and contact details.  
• Bring requested insurance and photo identification to our office. 
• Be ready to discuss any symptoms, questions or concerns you may have. 
• Tell your doctor about medications or supplements you’re taking. 
• Arrive early and allow time to complete any necessary paperwork. 
• Make transportation and other plans, including arrangements for someone to help you before and after surgery or during your appointments. 
• Notify your care team of any changes in your condition. 
• Carefully follow pre- and postsurgery instructions.

Before your abdominal hernia surgery

Your plastic surgeon explains your procedure and tells you what to do and what to expect. If it’s a complex hernia, your doctor may talk about whether the use of medical mesh is indicated.

Studies show that mesh reinforcement can help prevent recurring hernias at the site of complex hernias. Your surgeon will explain the types of mesh material, benefits versus risks and safety measures the Ohio State Wexner Medical Center takes to ensure your best possible outcome.

Before abdominal hernia surgery, you may get antibiotics or other medicine, and be instructed to delay or stop certain medications or supplements. Before surgery:

1. A nurse calls you to tell you when and where to arrive, what to wear, when to stop eating and other directions. 
2. The morning of surgery, you see either your plastic surgeon or your general surgeon. We encourage you to write down any questions so that your surgeon can address any last-minute concerns. 
3. Your nurse starts an IV line in your wrist, arm or elbow, and you receive medications by IV, including medicine to help you relax. 
4. Once in the operating room, we transfer you to a warm operating room table, and the anesthesiologist gives you an oxygen mask to help you breathe. 
5. You’ll count backward from 10 as you breathe in a general anesthetic until you fall asleep. In what may seem like an instant, you’ll wake up in the recovery room, where nurses care for you before moving you to a hospital room.  
6. In rare instances, some patients go to the intensive care unit (ICU) for specialized care and monitoring.

During your abdominal hernia surgery

Abdominal reconstruction is performed using a general anesthetic so that you sleep throughout the procedure and won’t feel anything. Your general surgeon makes an incision and repositions displaced intestinal or other organs, muscles and tissues. Your general surgeon removes any scar tissue or medical material from a previous procedure.

For complex hernias, your plastic surgeon steps in to move separated muscles back together. The surgeon repairs and rebuilds the abdominal wall. If you have a complex hernia and your treatment plan includes hernia mesh, the doctor will sew it on to hold, protect and reinforce muscle and tissue.

Surgery can range from two to eight or more hours, depending on your age, condition, hernia size, complications from prior surgeries and other factors. You’ll stay at the hospital one or more nights.