Hernia repair is one of the most frequent surgical procedures in the United States, with the Food and Drug Administration reporting over one million operations annually. However, hernias can reappear at or near a previously repaired site, creating what is known as a recurrent hernia.
The risk of recurrence depends on several variables, including the type of hernia, the method used for the initial repair, and the patient's general health. According to Joanna Grudziak, MD, an abdominal wall, trauma, and emergency general surgeon at University of Utah Health, there is a growing movement to treat hernias as if they are a chronic disease, noting that each subsequent repair carries a higher risk of recurrence.
Certain types of hernias carry higher risks of returning. Ventral, parastomal, and incisional hernias show the highest recurrence rates, whereas inguinal hernias in the groin area have a lower risk.
Several common factors can contribute to a hernia returning after surgery:
Technical complications during the repair process
Infection of the surgical wound or improper healing
Being overweight
Factors that impact wound healing, such as diabetes and smoking
A large size of the initial hernia
While some recurrent hernias may only require regular monitoring if they are not bothersome, surgery might be recommended if the hernia causes significant pain, bowel blockages, or involves a large amount of intestine or tissue.
Research indicates that approximately 1 in 6 adults in the U.S. undergo hernia repair surgery within 10 years of their original operation. Drudziak stated that when treating patients with multiple repairs, the focus remains on whether the impact on quality of life justifies the risks of another operation.
Treatment options for recurrent hernias can be more complex than initial repairs and may include minimally invasive methods such as:
Laparoscopic surgery, which uses a camera through small incisions to close the hole and reinforce it with synthetic mesh.
Robotic surgery, which utilizes a robotic system to assist surgeons in reaching anatomically difficult or smaller spaces.
University of Utah Health utilizes a multidisciplinary approach to manage hernia care and reduce the likelihood of complications. This team-based strategy includes support for nutrition, smoking cessation, pain management, and physical therapy to build core strength.
Drudziak noted that having a care team familiar with these specific hernias, including surgeons, nurses, and therapists, helps in successfully managing complex patients and reducing complications that could lead to recurrence.
