The Complex Hernia Center at The Jewish Hospital specializes in treating the most complex types of hernias, including recurrent hernias and hernias complicated by obesity. It is the first center of its kind in the region dedicated solely to the treatment of these types of complex hernia cases.
Large Incisional hernia
This hernia occurs at the site of a surgical wound that didn’t completely heal. When this type of hernia appears in the abdomen, it is often referred to as a ventral incisional hernia.
This hernia is the result of an unsuccessful hernia repair or complications from a previous hernia repair such as a mesh infection or enterocutaneous fistula. It is characterized by the return of the bulge at or near the site of the previous hernia. These are very common situations, but difficult to treat and require a complex approach to repair.
This is often misdiagnosed as a hernia but is actually a weakening of the abdominal wall that requires a surgery similar to a complex hernia repair.
As these situations are very complicated, a staged process is used to provide the best long term outcomes. First, patients undergo healthy weight loss, either by our specialized trained bariatric medical physician or a bariatric surgery. After the necessary weight loss and weight stability goals have been reached, the hernia repair is performed, sometimes with simultaneous removal of the extra skin and tissue that develop after the weight loss. If not, a staged reconstructive body contouring surgery to remove the heavy tissue folds is performed for ideal, lasting results.
A collaborative approach to complex hernias
Our approach to complex hernia repair is multidisciplinary, collaborative and compassionate. Two surgeons, a bariatric surgeon and a reconstructive plastic surgeon work together as a team. Both have advanced training and extensive experience in complex hernia repair and advanced abdominal wall reconstruction. Together, and typically collaborating with a referring general surgeon, they ensure the best outcome, based on a patient’s specific diagnosis and needs.
Along with a team of dedicated nurses, dieticians, and wound care specialists, our multidisciplinary approach ensures that all aspects of complex hernia repair and recovery can be handled at one location at the Jewish Hospital, where will you find a unique combination of fellowship-trained surgeons, cutting-edge technology and the most advanced surgical techniques specializing in complex hernia repair.
The most advanced treatments for complex hernias
We have the ability to perform a range of procedures, including:
- Incisional hernia repair: This surgery involves making an incision over the site of the hernia. To do this, we place the contents of the hernia back inside the abdominal cavity and repair the abdominal wall with mesh and sutures.
- Robotic incisional hernia repair: This minimally invasive procedure entails making small, “keyhole” incisions to repair a hernia. Using a video camera, we pull the hernia contents back into the abdominal cavity, close the hernia with sutures, and place a mesh to the area.
- Advanced component separation: Patients with large incisional and/or recurrent hernias may benefit from more advanced techniques, such as anterior component separation, posterior component separation, and transversus abdominis release. These procedures allow us to bring the muscles together to more closely recreate a normal abdominal wall.
- Soft tissue reconstruction: Our surgeons remove excess skin and scar tissue that may need to be removed at the time of the procedure. This is often seen in patients who have had bariatric surgery or multiple hernia procedures. By using advanced plastic surgery techniques, we manipulate tissue to cover wounds or defects that were previously unable to heal correctly.
We submit our surgery outcomes to a national database maintained by the Americas Hernia Society Quality Collaborative (AHSQC). The AHSQC utilizes concepts of continuous quality improvement to help achieve better patient outcomes. This is accomplished through patient-centered data collection, ongoing performance feedback to clinicians, and improvement based on analysis of collected data and collaborative learning. This enables us to compare our outcomes to hernia centers around the country and apply national best practices to our patients here in Cincinnati.