Abdominal wall reconstruction

Your consultant may recommend abdominal wall reconstruction if you have an abdominal wall hernia due to previous surgery, injury, or disease.

Some conditions abdominal wall reconstruction can be used to treat include:

• Simple abdominal hernias
• Incisional hernias
• Infection after surgery
• Certain types of cancer
• Open wounds in the abdominal wall
• Wounds after hernia repair
• Rectus muscle separation (diastasis recti) - separation of the abdominal muscles during pregnancy

Abdominal wall hernias can also have a significant impact on a person’s health and quality of life. Some benefits of abdominal wall reconstruction include:

• Reduces the risk of strangulated hernia (a rare but very serious problem where the blood supply to herniated organs is cut off)
• Restores stability
• Reduces back pain
• Improves mobility
• Improves confidence and self-esteem

Your consultant will ask you about your symptoms, general health, and medical history. They will perform a physical examination and may order imaging scans such as an ultrasound, CT, or MRI.

At Circle Health Group, your first appointment is very important. It's not only where we start our diagnosis but also where we begin to get to know you, discuss your expectations for treatment and discuss any questions or concerns you may have.

At the end of your appointment, your consultant will decide whether abdominal wall reconstruction is a suitable procedure for you based on your symptoms, diagnosis, general health and medical history. They will explain the surgery to you, including what happens during the procedure, any possible risks, and complications, and what to expect during your recovery.

Your consultant will tell you everything you need to do to prepare for your surgery. If there's anything you're not sure about, or if you have any questions about how to prepare for your surgery, speak to your consultant or call the hospital for advice. Being well-prepared for your surgery will help to ease any anxiety you may have as well as allow your surgery and recovery to go more smoothly.

Before your surgery, tell your consultant about any medical conditions or allergies you have and any medication, including over-the-counter medicines you are taking.

Your consultant may tell you to stop taking some medications like blood thinners before your operation. This is to reduce the risk of bleeding during and after your surgery.

You will not be able to eat or drink anything from midnight on the day of your operation.

What lifestyle changes can I make before my surgery?

Being in optimal health before your surgery can reduce the risk of complications and speed up your recovery.

To make sure you are as healthy as possible before your surgery:

• Lose weight if you need to
• Eat a healthy, balanced diet with plenty of fruit, vegetables, lean proteins, and whole grains
• If you smoke, you must stop at least eight weeks before your surgery
• Avoid alcohol for a few days before and after your surgery. Alcohol thins the blood and can increase the risk of bleeding
• Take regular exercise

Do I need to prepare my home for after my surgery?

You may feel quite tired and need help with some daily activities for a while after your surgery. Arrange for someone to help with household tasks like shopping, cooking, and cleaning for at least the first few days after you are discharged.

Before your surgery, prepare your home to make things as easy as possible during your recovery. Some things you can do include:

1. Stock up on easy-to-prepare meals
2. Prepare single-portion meals that can be easily heated up
3. Remove items you could trip over such as low tables, magazine stands and rugs
4. Keep things you use frequently like books, medications, and the TV remote control within easy reach

The operation can take from two to eight hours depending on the type of surgery you have. Your consultant will give you a good estimate based on your personal circumstances.

Abdominal wall reconstruction can be performed laparoscopically (keyhole surgery) or as open surgery. Your consultant will decide which is the best option for you.

Once your anaesthetic has taken effect, your consultant will make an incision (cut) over the hernia. The hernia is then located and returned to its correct position in the abdominal cavity.

The abdominal muscles are repaired layer by layer. Often surgical is sandwiched between the layers to strengthen the repair.

When the abdominal wall has been repaired, the incision is closed using dissolvable stitches, and a sterile dressing is applied.

After your surgery, you will be taken to the recovery room where you will be monitored closely until the effects of the anaesthetic have worn off. You will then be taken to your room. You will have surgical drains in place to drain any fluid after your surgery. These will be removed after a few days.

It's normal to have some pain and discomfort after your surgery. You will be given medication to help manage this while you are in hospital and your consultant can prescribe painkillers if needed when you are discharged.

You can take a shower from the day after your surgery but avoid swimming or bathing for three weeks after your procedure.

Avoid heavy lifting for at least three weeks after your surgery.

How many nights will I need to stay in hospital?

How long you need to spend in hospital after your surgery can vary from a couple of nights to around a week and depends on the details of your operation as well as your age, general health and whether there were any complications during your surgery. Talk to your consultant about how long you can expect to stay in hospital after your surgery.

Will I be able to drive home?

You will not be able to drive yourself home from hospital after your abdominal wall reconstruction. Please make arrangements for someone to collect you, and care for you for the first few days after you are discharged from hospital.

How soon can I go back to work?

How soon you can go back to work after your surgery depends on what was done during your procedure, your individual recovery, and the type of job you do. We recommend taking at least two weeks off work after your surgery, longer if your job is very physically demanding or involves heavy lifting.

Talk to your consultant about when you can expect to return to work after your surgery.

How soon can I drive?

You should not drive until you can wear a seatbelt comfortably, control your vehicle and perform an emergency stop safely. This is normally at least two weeks after your surgery. Check with your consultant and get the all-clear from your insurance company before driving after your surgery.

When will I be back to normal?

Recovery from any type of surgery is a gradual process that is different for everyone. Abdominal wall reconstruction is major surgery and it's important to go at your own pace during your recovery. Increase your activity level gradually and stop if you feel tired or have pain. Follow your consultant's instructions carefully during your recovery and call the hospital if you have any questions or concerns.

On average, it takes around two to three months to resume normal activities after abdominal wall reconstruction surgery.

As with all types of surgery, abdominal wall reconstruction carries a small risk of complications. Your consultant will explain all the possible risks and complications before your surgery and answer any questions you may have. Please make sure you are fully informed about the possible risks and complications of surgery and able to make an informed decision.

Possible complications of any surgery include:

• Bleeding
• Infection
• Blood clots
• Chest infection
• Adverse reactions to the anaesthetic

Possible complications specific to abdominal wall reconstruction surgery include:

• Wound seroma - a build-up of clear fluid where the hernia used to be. It normally resolves without treatment, but in some cases may need to be drained
• Injury to the bowel or surrounding structures
• Bowel ileus - when the bowel doesn't work properly for a time after surgery
• Intra-abdominal hypertension - increased pressure in the abdomen
• Recurrence of the abdominal hernia
• Irregular appearance - the two halves of your abdomen may appear uneven and there may be loose skin or excess tissue. In some cases, the belly button may need to be removed during surgery.

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about abdominal wall reconstruction, book your appointment online today or call a member of our team directly.

Content reviewed by Circle in-house team in March 2023. Next review due March 2026.

1. Abdominal wall reconstruction, NIH
2. Abdominal wall reconstruction, North Devon Healthcare NHS Trust
3. Abdominal wall reconstruction, Imperial College Healthcare NHS Trust
4. Abdominal wall reconstruction, Medscape