Hernia Surgery

Dr. Hernández specializes in the surgical treatment of all types of hernias. When dealing with complex hernias, he follows a carefully designed treatment plan to ensure optimal outcomes. With extensive expertise, Dr. Hernández is highly skilled in managing not only standard hernias but also the most challenging and demanding cases.

What is a Complex Hernia?

A complex hernia typically occurs at the site of a previous hernia repair or surgical incision. The presence of a fistula or prior mesh placement can further complicate the repair. Patients should seek a specialist in complex hernia repair if they have:

• A hernia defect greater than 8 cm

• Loss of abdominal domain

• Fistulas or a history of mesh infection

• Multiple failed hernia repairs

• A history of prior open surgery

• A body mass index (BMI) >35

• High-risk medical conditions such as diabetes, obesity, or a history of smoking.

Causes of Complex Hernias

A hernia occurs when an organ or tissue pushes through an opening in the abdominal wall or groin. Contributing factors include:

• Prior open surgery

• Heavy lifting

• Chronic diarrhea or constipation

• Obesity

• Prolonged coughing or sneezing (e.g., COPD)

Who Needs Abdominal Wall Reconstruction?

Patients with complex hernias, a history of failed hernia repairs, or abdominal trauma may require abdominal wall reconstruction. Large hernias can cause abdominal deformities, discomfort, and a significant impact on quality of life. These hernias do not resolve without surgical intervention.

The Procedure

Abdominal wall reconstruction can be performed using either open or minimally invasive techniques, depending on the complexity of the case. The procedure involves general anesthesia and typically includes muscle and fascia repositioning, as well as mesh insertion to reinforce the repair. The duration of surgery varies, ranging from two to five hours or more, depending on factors such as the patient’s age, medical history, hernia size, and previous complications.

To optimize outcomes, Dr. Hernández employs preconditioning techniques before surgery, including Botulinum toxin type A (BTX) injections and progressive pneumoperitoneum (PPP), which enhance the flexibility and compliance of the abdominal wall.

Dr. Hernández’s expertise in complex hernia repair and abdominal wall reconstruction ensures that patients receive the highest level of surgical care, improving their comfort and quality of life.