Hernia recurrence is another way of saying that a hernia has returned; that the defect has re-opened after having been repaired. Hernia recurrence is, unfortunately, a real postoperative concern, but with new mesh technology, and improvements in laparoscopic and robotic technique, recurrence is not common, with a risk of about 1 to 2%.
There are many factors that affect hernia recurrence risk. Some of these include:
- Open surgery. A single, large incision created to repair the hernia also increases the chance that an incisional hernia can develop. Fortunately, most hernias are now repaired using minimally invasive surgery that only requires tiny incisions in the abdomen.
- The patient’s general health and lifestyle may also affect their chances for recurrence. Smokers, those who are obese, and those who are in generally poor health have a higher chance of hernia recurrence then those in good shape who eat well and maintain a normal weight.
- Improper selection of mesh, particularly the size of the sheet of mesh, is often implicated in hernia recurrence. If the piece of mesh used to cover the defect is not large enough – in other words, it doesn’t overlap enough tissue around the hernia, there is a chance that pressure on the mesh can cause it to fail. A very experienced hernia surgeon such as Dr. Higa avoids this concern by selecting an appropriate mesh size for the patient’s individual circumstance using his experience and knowledge.
How we handle recurrence
Unfortunately, a recurrent hernia repair comes with significantly more risk than the initial hernia procedure. The initial procedure implants mesh, which allows scar tissue to grow over it. As a result, there is a significant amount of additional tissue in the surgical area. Old mesh, from the initial hernia repair, also needs to be addressed. However, despite the added complexity of the procedure, recurrent hernia repairs are typically very successful, and, in the hands of an experienced hernia surgeon, should allow the patient to live a normal, pain-free and fully-active life.