Complex Hernia Center
The Overland Park Regional Medical Center Complex Hernia Center is a multidisciplinary program providing state-of-the-art care for all types of hernias, from the most common to the most complex. Our board-certified, fellowship-trained surgeons focus on a broad range of abdominal wall defects, ranging from inguinal hernias to those that may require complex abdominal wall reconstruction.
Hernia Treatment at Overland Park Regional Medical Center
At Overland Park Regional Medical Center, we offer personalized treatment plans and multidisciplinary care for all types of hernias. Our multidisciplinary treatment team includes board-certified, fellowship-trained surgeons who specialize in all types of hernia repair from the traditional, open technique to laparoscopic or minimally invasive surgery.
Our multidisciplinary team includes wound care specialists, heart care, diabetes care, registered dietitians, physical therapy and rehabilitation as well as access to the area’s most advanced bariatric surgical treatment for weight loss and physician-directed medical weight loss programs.
Preparing for a Successful Complex Hernia Surgery
Because factors like smoking, obesity, uncontrolled diabetes, poor nutrition and previous wound infections can diminish the success of hernia surgery, our surgeons counsel hernia patients before surgery to help lower known risk factors. Smoking cessation, adequate control of diabetes, weight management, and proper nutrition are necessary elements for achieving a successful, lifelong hernia repair.
Our patients are required to have a healthy weight, control their diabetes, and stop smoking before undergoing a complex hernia procedure.
Complications can range from small bowel obstruction, infection, reoccurrence, and incarceration to strangulation. Some complex hernias are the result of an organ other than the intestine bulging through the abdominal wall. The appendix, ovaries, fallopian tubes, spleen, or Meckel's diverticulum may be inside the hernia sac. Recurrent hernias are often due to the scar tissue around the incision point thinning and growing weak, which makes them difficult to repair.
When a hernia develops a complication, such as infection, incarceration, or strangulation or doesn't respond to hernia surgery, it may be due to one or more of the following reasons:
- thinning or weakening at previous incision
- congenital defect that causes weak spots in the abdominal wall
- corticosteroid dependency
- wound infection; sepsis
- chronic pulmonary disease
- abnormal connections between two organs (fistulas)
- repeated abdominal pressure after surgery
- inadequate hernia repair
Aging is another factor that can lead to complex hernias. Lifestyle choices, including frequent strain and intense pressure on the abdomen, smoking, obesity, and possibly smoking can also lead to more complex hernias, including recurrent hernias after surgery.
A diagnosis of complex hernia involves a physical examination of your symptoms and the hernia. Symptoms of complex hernia include redness, pain, hardness or tenderness of the hernia. An irreducible or recurrent hernia is another symptom of a complex hernia. We will review your medical history and discuss any previous hernia surgery, chronic illness or congenital defects before making a final hernia diagnosis.
Laparoscopy repair is a minimally invasive procedure; a few small incisions are made in your abdomen. The surgeon places a tiny laparoscope (a viewing tube with a camera) and small instruments through the incisions. The organs or tissues are pushed back into their original position and the abdominal wall is reinforced with a special mesh that is secured by sutures, stables, or tacks.
Most non-complex hernia laparoscopic repair patients experience minimal pain and scarring and a return to their normal activities within a week to 10 days. Laparoscopic hernia repair may be a good choice for patients who have previously had traditional hernia surgery because it can allow the surgeon to avoid scar tissue from the earlier surgery.
Open Hernia Repair is when the surgeon makes an incision in your abdomen or groin and the bulging intestine or tissue is pushed back into place and sewed securely. The weakened area is usually reinforced and supported with a mesh material.
Patients can expect to be hospitalized an average of 5-10 days following complex open hernia repair. You will be encouraged to move about soon after surgery, but it may be 4-6 weeks before you are fully able to resume normal activities.
complex hernias are more common when early diagnosis and treatment are avoided. There are different types of complex hernia based on where the hernia occurs and the health complications involved.
Inguinal hernias are the most common type of abdomen-related hernia; however, less than 15 percent of adults who undergo hernia surgery need to return for additional surgery.
complex hernias are more common in older adults and younger children.
complex hernias due to incarceration -irreducible hernias - and strangulated hernias are more common with femoral hernias because of the narrowness of the passageway that runs from the abdomen to the upper thigh.
Although hernias are common in children, teens, and adults, complications that occur are usually mild and can be treated effectively with surgery, diet, and lifting restrictions.
A complex hernia can affect the body in different ways. A hernia that becomes incarcerated can be painful, uncomfortable, and lead to another serious complication called strangulation. Strangulated hernias need immediate medical attention to prevent the part of the intestine outside the wall from dying. A recurrent hernia is a complex hernia that reappears after hernia surgery.
When additional hernia surgeries are needed, the procedures can affect the health of your abdomen wall and increase your recovery time. More surgery can lead to more scar tissue and in some cases further weakening of the abdominal wall. A complex hernia that blocks part of your bowel affects your ability to have a bowel movement, which is both uncomfortable and can be potentially life threatening if left untreated.
Other than surgery, there are no approved alternative treatment options for correcting a complex hernia. Eventually, surgery is needed to repair most types of hernias. The following lifestyle choices can help you manage milder hernia symptoms as well as treat a hernia when surgery is not an option.
- Quit smoking
- Maintain a healthy weight
- Avoid intense straining of the abdomen
- Learn to lift heavy objects correctly
- Eat high-fiber foods to prevent constipation
- Treat the cause of frequent coughing (such as smoking), sneezing, or vomiting
- Use a truss to support your hernia (doctor-approval needed)
Hernia trusses should not be worn for long durations of time or in place of surgery and can actually cause hernias to develop complications. A complex hernia that is painful, irreducible, and/or causes frequent vomiting and fever, needs immediate medical attention.
Preventing weakness in the abdominal wall is the best way to prevent a hernia; however, congenital weakness in the abdominal wall cannot be prevented. Early diagnosis and treatment of a hernia can help lower your risk for complications due to intense pressure on the abdomen, smoking, obesity, illness, or infection. complex hernias that develop suddenly - incarcerated, strangulated - are difficult to prevent because there is no single cause for a hernia becoming incarcerated.
Hernias that are left untreated increase your risk for a complex hernia. Your risk for a complex hernia also increases if one or more of the following factors are present:
- ongoing infection or infection in the hernia surgery incision
- congenital weakness of the abdominal muscle wall
- fistulas - abnormal connections between two organs
- multiple hernia surgeries
- inadequate hernia repair
- ignoring post-surgery physical restrictions
- frequent pressure or straining of the abdomen
Chronic illness or smoking that causes frequent coughing and/or sneezing may also increase your risk for complex hernias.