Hernias occur when tissue or an organ pushes through a weak spot in an abdominal muscle and are usually repaired surgically. While the majority of hernia surgeries are successful, there is a chance that a hernia could return months or even years after hernia surgery.
When hernias reappear near or at the location of a previous repair, they are called recurrent hernias.
What are the risk factors for recurrent hernias?
A recurrent hernia can happen for many reasons, such as a surgical error, the sutures holding the abdominal muscles together becoming less effective over time or a surgical wound that has not healed properly.
Additionally, recurrent hernias can be caused by various conditions, behaviors and activities that strain or weaken the abdominal muscle after the initial repair. These include:
Steroids, chemotherapy or other medications that compromise the immune system
Heavy lifting or other strenuous activities
What are the signs and symptoms of recurrent hernias?
Signs and symptoms include:
A bulge at or near the site of the original hernia
Pain — which can range from a dull ache to severe pain — especially when coughing, sneezing or lifting heavy objects
Bloating or constipation
How are recurrent hernias diagnosed?
Your doctor will carefully examine your abdominal area after reviewing your medical and surgical history. You could be asked to stand and cough so the doctor can see or feel a bulge that would indicate that your hernia has returned.
If you have a recurrent hernia, your doctor may order imaging tests to help determine the hernia's location and inform a treatment strategy. These include:
Computed tomography (CT) scans
Magnetic resonance imaging (MRI) scans
What are treatment options for recurrent hernias?
Treatment options include:
Observation: In some more mild cases, your doctor may recommend continuing to observe the hernia before taking action.
Elective surgical repair: Recurrent hernias can sometimes cause excessive pain or discomfort. If that is the case for you, your surgeon may recommend elective (non-emergency) surgical repair.
Emergency surgical repair: In rare cases, urgent or emergency surgery is needed. This approach will be recommended if a recurrent hernia threatens to strangle a portion of the intestine.
Surgically repairing a recurrent hernia entails closing and reinforcing the defect in the abdominal wall, often with synthetic mesh material. The method your doctor recommends will depend on your hernia's size and location, your general health and how physically active you hope to be in the future.
What are the surgical options for recurrent hernias?
The surgeons at the Brigham's Hernia Program apply the latest advancements in hernia repair into each surgery. They practice many different types of hernia surgeries, including:
Open hernia repair: This involves making an incision over the hernia site and pushing the bulging tissue or organ back in place. The surgeon then closes the hole with sutures or with a combination of sutures and plastic mesh.
Laparoscopic hernia repair: This is a minimally invasive procedure in which small incisions, a tiny video camera, special surgical tools and a piece of plastic mesh are used to repair the hernia.
Robotic hernia repair: This procedure is similar to laparoscopic repair. In this case, however, your surgeon uses robot-assisted technology to guide the movements of the surgical tools precisely.
Complex hernia repair: This involves separating the different layers of the abdominal wall to create a more durable repair.
How do you make an appointment?
To learn more about the Hernia Program's multidisciplinary approach to patient care or to schedule an appointment with one of our specialists, please call 617-525-9726. Our providers see patients at the following locations: