Sometimes, hernia patients who have undergone surgery are shocked to find that a bulge has started developing again at the site of the surgery or in the area surrounding it. While other complications like infection or bleeding can cause this symptom too, another possible complication is that the hernia has occurred again, i.e., the recurrence of a hernia.
With the recent use of novel techniques and prostheses (like meshes), recurrence is not very common (0.2%-10% globally, with the lowest rates at specialized hernia centers); however, if they do occur, they require reoperation.
Here, at Chennai Hernia Centre, our experts are proficient in hernia surgery, with very low rates of recurrence, but also have experience in treating cases that present with recurrence after initial surgery elsewhere.
Recurrent hernias can be quite simply understood as a breakdown of previous hernia surgery. Previous hernia surgery breakdown can happen due to multiple reasons, which are often not clearly distinguished. Some causes are:
Due to the nature of these hernias, your initial hernia surgery must be performed well, with careful follow-up. Dr. Rengan at Chennai Hernia Centre has decades of experience with hernia surgery with very low rates of recurrence, and is, therefore, best suited for all your hernia needs
The recurrent hernia is very similar to the original hernia, occurring at the same site or near the surgical site. Like all hernias, they are a bulge that may be painless. However, due to the cause of the hernia (infection, tissue breakdown, etc), there may be the presence of pain. Pain, like in all hernias, is a cause for concern and requires attention from medical professionals. Apart from these, be on the lookout for:
All of the above require urgent medical attention, especially if they occur suddenly in concomitance with pain, as it can signal hernia strangulation, a situation in which the bowel loop involved in the hernia is cut off from the blood supply.
At first, a detailed history will be collected from you including your entire medical and surgical history. Following this, the recurrent hernia will be examined carefully. Our doctors will also try to establish the cause of the hernia at that point. Ultrasound imaging (or in some cases, CT or MRI) will be required for further evaluation of the extent of the hernia. Since these hernias occur over a site of surgery, they are not purely the prior hernia, but also involve aspects of incisional hernias. All this requires careful evaluation and planning for the subsequent surgery. Apart from the imaging tests, some blood tests will also be prescribed. After evaluating all these parameters, we will have a detailed conversation with you regarding your surgical options.
Unfortunately, a recurrent hernia is not a simple complication that can be treated by medicines or lifestyle measures alone. With the breakdown of the initial surgery, the risks faced by the patient subsequently increase. Therefore, the best course of action is to reoperate, this time with a prosthesis for reinforcement, to ensure that failure of surgery does not recur again.
The choice and type of surgery will be decided based on many factors including your current medical condition, what surgery was previously done, the area involved by the hernia, as well as the cause of recurrence. Surgeries are broadly divided into:
In general, for recurrent hernias, the original scar will be avoided and the hernia approached through a higher incision to reduce further risk of scar weakness and recurrence.
Both types of surgery are done under general anesthesia and may only require admission for a couple of days depending on your other medical factors. Importantly, return to daily activities must be carefully monitored to avoid undue strain on the incision site. If factors like chronic cough or other conditions complicated recovery the previous time, these factors will be addressed specifically as well. Similarly, follow-up will be done carefully and rigorously. Please make sure to attend the follow-up visits as instructed.