Outcomes from incisional hernia repair
February 26, 2021 4:51 PM Subscribe
Two years post-surgery, I have developed a long incisional hernia around my umbilicus. Surgeon wants to mesh it, remove my belly button (common site for infection), and stitch me up. Until she gets in there, she won't know where the mesh will actually be attached. She warned of ongoing issues including chronic pain and a need to redo the surgery later. I am after personal experiences of incisional hernia repair, and recovery tips. Can you help?
Fuck cancer.
Fuck cancer.
Best answer: Even if the repair is not guaranteed long-term, it's important to know that umbilical hernias nearly always worsen, and repair becomes even more difficult the larger they are.
Yep! For me, that was a deciding factor when I had this surgery in January 2020. I developed a hernia after major abdominal surgery the previous summer, and at the time of surgery, the hole itself was about the size of a silver dollar. The doctor predicted it would only get worse without intervention.
I had a positive experience. My doctor had been doing this particular surgery for more than 20 years, and he could count on one hand (and have a couple of fingers left over) the number of failures that had required a second surgery. He used the mesh (it looks kind of like the mesh on football uniforms, or wrapped around certain kitchen scrubber sponges) and he even let me look at a sample of the stuff in the office. He followed the line of the older scar so it looked the same after healing. I still have a bellybutton. My surgery was inpatient, but it made for a very long day. And as with your surgeon, it was a case of needing to begin surgery to know exactly how to proceed.
This was my second of three abdominal surgeries in the space of a single year, and as far as abdominal surgeries go, it was about the same for all three. Serious painkillers at first, then I was fine with Tylenol within a few days, but pain is different for everyone. I moved very slowly. I had to sort of roll out of bed for a long time. I couldn't lift anything heavier than five(?) pounds for 4-6 weeks. Afterward, I lost a significant percentage weight while dealing with a separate issue, and then gained it all back and more several months later, and also had another unrelated abdominal surgery. So yes, the mesh stretches!
My only real problems with this were coming out of the anesthesia (which always happens), and then needing oxygen at home for a while afterward. My oxygen saturation typically drops after surgery, though, so if I had had a conventional hospital stay afterward, I may not have needed it at home.
All in all, I was happy to have it done. And for me, it turns out to have been an especially good thing as the unrepaired hernia would have prevented me from getting my transplant four months later.
posted by mochapickle at 6:05 PM on February 26, 2021 [4 favorites]
Yep! For me, that was a deciding factor when I had this surgery in January 2020. I developed a hernia after major abdominal surgery the previous summer, and at the time of surgery, the hole itself was about the size of a silver dollar. The doctor predicted it would only get worse without intervention.
I had a positive experience. My doctor had been doing this particular surgery for more than 20 years, and he could count on one hand (and have a couple of fingers left over) the number of failures that had required a second surgery. He used the mesh (it looks kind of like the mesh on football uniforms, or wrapped around certain kitchen scrubber sponges) and he even let me look at a sample of the stuff in the office. He followed the line of the older scar so it looked the same after healing. I still have a bellybutton. My surgery was inpatient, but it made for a very long day. And as with your surgeon, it was a case of needing to begin surgery to know exactly how to proceed.
This was my second of three abdominal surgeries in the space of a single year, and as far as abdominal surgeries go, it was about the same for all three. Serious painkillers at first, then I was fine with Tylenol within a few days, but pain is different for everyone. I moved very slowly. I had to sort of roll out of bed for a long time. I couldn't lift anything heavier than five(?) pounds for 4-6 weeks. Afterward, I lost a significant percentage weight while dealing with a separate issue, and then gained it all back and more several months later, and also had another unrelated abdominal surgery. So yes, the mesh stretches!
My only real problems with this were coming out of the anesthesia (which always happens), and then needing oxygen at home for a while afterward. My oxygen saturation typically drops after surgery, though, so if I had had a conventional hospital stay afterward, I may not have needed it at home.
All in all, I was happy to have it done. And for me, it turns out to have been an especially good thing as the unrepaired hernia would have prevented me from getting my transplant four months later.
posted by mochapickle at 6:05 PM on February 26, 2021 [4 favorites]
Oh! I said above that my surgery was inpatient. I meant to say outpatient! :)
posted by mochapickle at 7:28 PM on February 26, 2021
posted by mochapickle at 7:28 PM on February 26, 2021
Response by poster: in those cases an abdominal "binder" was prescribed to reduce the abdominal pressure on the weakened abdominal wall - perhaps you already have one.
No, not prescribed. If I had known this hernia was a potential issue when I had the cancer surgery, I would have worn a supportive binder/truss afterwards.
I've just bought one now with the hope that it will stop the hernia from getting bigger.
See! Your experiences have helped already. More are welcome.
posted by Thella at 8:14 PM on February 26, 2021 [1 favorite]
No, not prescribed. If I had known this hernia was a potential issue when I had the cancer surgery, I would have worn a supportive binder/truss afterwards.
I've just bought one now with the hope that it will stop the hernia from getting bigger.
See! Your experiences have helped already. More are welcome.
posted by Thella at 8:14 PM on February 26, 2021 [1 favorite]
Best answer: I don't want to be a bearer of bad news, but my hernia repair story isn't a great one.
In my case, my docs booked me for a hernia repair a several months off in the future, and before I got to that point, it incarcerated my bowel (ie cut it off including blood flow). I wound up with an emergency repair with mesh. A couple of years later, (it's suspected) the mesh detached and perforated my bowel, which led to a second emergency repair; at some point, it got colonized by MRSA which ultimately led to two more surgeries over the following years.
Knock wood, the most recent surgery seems to have worked, in that my wound has healed and I haven't had problems for the past couple of years, but that story was a decade start to finish. To be fair, I was on immunosuppressants pretty well the entire time, so problems with healing are unsurprising.
I'd recommend getting it sorted out early, for one. I wound up in the end with a bio-mesh which was apparently incredibly expensive but was a far better option for me (and couldn't perforate anything). My surgeries generally involved a week or so inpatient, but I understand that here in Canada the hospital stays are longer. +1 on the binder.
I'm sorry to have given you a not-great outcome; it's not the only one possible or likely of course.
posted by Superilla at 11:48 PM on February 26, 2021 [2 favorites]
In my case, my docs booked me for a hernia repair a several months off in the future, and before I got to that point, it incarcerated my bowel (ie cut it off including blood flow). I wound up with an emergency repair with mesh. A couple of years later, (it's suspected) the mesh detached and perforated my bowel, which led to a second emergency repair; at some point, it got colonized by MRSA which ultimately led to two more surgeries over the following years.
Knock wood, the most recent surgery seems to have worked, in that my wound has healed and I haven't had problems for the past couple of years, but that story was a decade start to finish. To be fair, I was on immunosuppressants pretty well the entire time, so problems with healing are unsurprising.
I'd recommend getting it sorted out early, for one. I wound up in the end with a bio-mesh which was apparently incredibly expensive but was a far better option for me (and couldn't perforate anything). My surgeries generally involved a week or so inpatient, but I understand that here in Canada the hospital stays are longer. +1 on the binder.
I'm sorry to have given you a not-great outcome; it's not the only one possible or likely of course.
posted by Superilla at 11:48 PM on February 26, 2021 [2 favorites]
Not umbilical, but I had an inguinal hernia (right side) last year, and had it corrected fairly early, before any complications. The procedure was done laparoscopically, and the surgeon installed mesh. She acknowledged that mesh can be problematic in some cases, but this was a newer type of mesh that had shown far fewer problems.
She asked for consent to repair the left side as well, if she found another hernia or early stages on the other side while in there, and I consented. She did find a smaller hernia on the left side, and also repaired it with mesh. I have two scars, each roughly 3/4" (18mm), one on each side of my abdomen, and a third in my belly button. I was home after a few hours, and I was back at work (on light duty) five days later. Two months later, I'd eased back into a workout routine, and by fall I was back into doing my full workout routine.
The surgeon did warn me about possible side effects including chronic pain, or the possibility of needing to go back in soon to correct it, but I've had two follow-ups in the year since, and she is completely satisfied with how it all healed. I have experienced no lasting side effects. The first couple days of recovery, I was very sore. The narcotic pain killers made me very constipated, which the surgeon said I must avoid at all costs. Stool softeners were prescribed and taken, but I also needed some milk of magnesia to counter the constipation. On the fourth day, I stopped taking the narcotics and switched to 800mg of ibuprofen as needed. The rest of my recovery was unremarkable.
posted by xedrik at 7:55 AM on February 27, 2021
She asked for consent to repair the left side as well, if she found another hernia or early stages on the other side while in there, and I consented. She did find a smaller hernia on the left side, and also repaired it with mesh. I have two scars, each roughly 3/4" (18mm), one on each side of my abdomen, and a third in my belly button. I was home after a few hours, and I was back at work (on light duty) five days later. Two months later, I'd eased back into a workout routine, and by fall I was back into doing my full workout routine.
The surgeon did warn me about possible side effects including chronic pain, or the possibility of needing to go back in soon to correct it, but I've had two follow-ups in the year since, and she is completely satisfied with how it all healed. I have experienced no lasting side effects. The first couple days of recovery, I was very sore. The narcotic pain killers made me very constipated, which the surgeon said I must avoid at all costs. Stool softeners were prescribed and taken, but I also needed some milk of magnesia to counter the constipation. On the fourth day, I stopped taking the narcotics and switched to 800mg of ibuprofen as needed. The rest of my recovery was unremarkable.
posted by xedrik at 7:55 AM on February 27, 2021
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Not personal experience. I'm a nurse with quite a bit of patient experience - I hope it's a helpful point of view. Good luck to you.
posted by citygirl at 5:37 PM on February 26, 2021 [2 favorites]