Primary hernias often develop in the abdomen due to weakened muscles after pregnancy, childbirth, or heavy lifting. Incisional hernias commonly occur after a prior entry or laparotomy into the abdomen. They are the specialty of Dr. Dumanian. Hernias even can occur after minimally invasive (robotic or laparoscopic) procedures, and these are called trocar site hernias. The sutures used to close the abdominal wall after laparotomy create scar tissue, but that scar (in many people) isn’t durable over time, leading to the development of a hernia.
Recurrent hernias occur when the initial repair of the hernia fails. Hernia repair is necessary to push the organ or tissue back through the muscle. Dr. Gregory Dumanian is a board-certified surgeon who performs hernia repair surgery of many types and can address recurrent hernias. He does NOT perform minimally invasive (robot) or groin hernias and refers these conditions to colleagues.
What Causes a hernia to develop after laparotomy, or a hernia repair to fail?
Most laparotomy closures and hernia repairs are successful, but a portion of them may fail over time. This could happen because the surgical wound developed an infection, or the patient was too active too soon after the surgery. The chronic use of steroids or a chronic cough may also increase the risk of recurrent hernias. Other risk factors include:
- Being overweight
- Diabetes
- Steroid use
- Chemotherapy
- Medications that affect the immune system
- Smoking
- Heavy lifting
What Should I Do If I Think a Hernia Developed or Came Back?
If you think your hernia has returned, contact Dr. Dumanian to discuss the next steps. He may order a CT scan, MRI, or ultrasound to diagnose the hernia.
You may have a recurrent hernia if you experience the following:
- A bulge near the surgical site
- Dull to severe pain that spikes when you cough, sneeze, or lift an object
- Constipation
- Bloating
The treatment for recurrent hernia varies based on your symptoms and the imaging results. Dr. Dumanian may recommend observation to see how the hernia progresses or elective surgery to relieve symptoms. Emergency surgical repair may be necessary if the hernia is pushing on a section of the intestines or the intestines bulge into the hernia, causing nausea, vomiting, infection, constipation, and lack of blood supply to the intestines.
What Kind of Surgery Is Best for Hernia Repair?
Dr. Dumanian will recommend a specific technique for recurrent hernias, such as open hernia repair, where an incision is made over the bulging area to push the tissue back and close the wound with sutures and plastic mesh. Complex hernia repair involves splitting layers of the abdominal wall to form a more durable repair of the weakened tissues.
Contact Dr. Dumanian in Chicago About Hernia Repair
Schedule a consultation to discuss your hernia concerns with Dr. Dumanian. Contact our office at Northwestern University’s Feinberg School of Medicine at (312) 695-6022.