When first hernia repair break down with a need to repair them again, it is called a recurrent hernia. Successive attempts to repair are a relatively complex process. When organs slip out of their original place through a weakness in the muscle into another cavity, it is called hernia. Remedial operations for a hernia are elective surgeries except when hernias are incarcerated or strangulated. Recurrent hernias come in different sizes and shapes. Results are based on the type of anaesthesia, operative approach, obesity and associated medical comorbidities.
Commonly before the advent of mesh repairs, recurrent hernias were discovered right above the pubic tubercle. Hernias of the internal ring and lateral portions and interstitial were commonly noticed due to the extensive usage of anterior onlay plugs and mesh repairs. Small and short-changing tails of the grafts around the spermatic cord were related to failures after an onlay graft repair, both lateral and medial to the plug. With the onlay graft being placed sutureless, recurrences were observed at the pubic tubercle. Inguinal hernias when they recur within the first year of operation are due to an infection that damages the repair or metabolic complications of the tissues of the groin. Another reason for recurrence is due to the methodology of surgical repair. Traditional hernia repair surgeries excised the hernial sac and a mesh stitched on the weak spot or hole. The reaction of the mesh takes time and during this period, if the patient develops any condition which increases the pressure inside the abdomen, like continuous cough/sneezing, excessive weight lifting, longstanding constipation, obstruction to urine outflow etc can lead to increased chances of hernia recurrence.
Generally, a recurrence of hernia after a previous open repair is best repaired by laparoscopic approach. Recurrence after a previous laparoscopic repair is best repaired with open method.
We help patients by performing dependable hernia operations and ensuring that the rate of recurrences is low. Our surgeries are perfectly suited to each individual case.Authored by Dr. Deepak Varma, MBBS, MS (General Surgery)
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