Abdominal wall reconstruction and complex hernia surgery 

 Large or complex abdominal wall hernias are a significant challenge for the people who endure them. At Aurora Health Care, we have a talented team of exceptional surgeons to diagnose this difficult condition. And with the highest volume of complex hernia surgery performed in Wisconsin, you can count on our team to treat you with expert skill.

What is abdominal wall reconstruction surgery?

Hernias are the result of tissue or an organ pushing through a weak spot or hole in the abdominal wall or groin. When hernias are large, complex or recurring, they may cause dysfunction in the tissue and muscles of the abdominal wall, resulting in the need for abdominal wall reconstruction. This complex surgical procedure aims to repair hernia damage and restore function to the abdominal wall.

Is reconstruction surgery the same as a tummy tuck?

 Sometimes, a tummy tuck (abdominoplasty) is referred to as abdominal wall surgery, but it’s not the same. Abdominoplasty is a cosmetic surgery that aims to improve the appearance of the abdomen by removing excess skin and fat and tightening the muscles. Abdominal wall reconstruction, on the other hand, is intended for repair of serious hernia issues.

 Who needs abdominal wall reconstruction?

Unlike treatment for more common hernias, abdominal wall repair is a complex operation reserved for serious cases. People who are likely candidates for this reconstruction surgery may:

• Have complex or recurrent hernias
• Have had prior hernia repair or multiple failed repairs
• Have suffered trauma to the abdomen

Conditions that may benefit from this surgery

Certain conditions and scenarios can result in the need for abdominal wall reconstruction:

• Incisional hernias, which are caused by weakened tissue after surgery
• Recurrent incisional hernias, which occur when previously fixed hernias come back
• Inguinal hernias, which occur in the groin between the abdomen and thigh
• Ventral hernias, which occur anywhere in the front of the abdomen
• Parastomal hernias, which are caused by weakened tissue around a stoma (small openings made during surgery, such as a colostomy, to help the body get rid of waste)
• Para ileal conduit hernias, a type of parastomal hernia, which happen specifically around an ileal conduit (a tube made from a portion of the intestine that carries urine from the kidneys outside the body)
• Atypical hernias, such as flank, lumbar, perineal or Morgagni hernias
• Enterocutaneous fistulas, which occur when a tunnel or passage forms between the intestines and abdominal skin, resulting in fluid or waste leakage
• Loss of abdominal domain, which happens when a large portion of organs have moved outside the abdominal cavity (usually in a hernia sac)
• Postpartum abdominal issues, which can result in conditions such as diastasis recti (weakened midline abdominal muscles)
• Organ transplant issues, which can cause hernias
• Infected surgical mesh, which is often used to strengthen the abdominal wall after surgery
• Chronic groin pain, which may be caused by weakened tissue or hernias

How is abdominal wall reconstruction and complex hernia surgery performed?

Because hernias sometimes cause a bulge in the abdomen, people mistakenly think hernias are tissue or a growth that should be removed. In reality, the treatment is to close the hernia.

With abdominal wall reconstruction and complex hernia surgery, the goal is to both repair hernias and bolster the function of the abdominal wall. Typically, the abdominal muscles and fascia will be repositioned, and surgical mesh will be inserted to help scar tissue form and reinforce your abdominal wall.

This operation can be performed using open surgery or with minimally invasive techniques, such as:

• Extended Totally Extraperitoneal (eTEP) repair, which accesses the hernia from the outside of the abdominal cavity lining instead of through the abdominal wall
• Robotic Transverse Abdominus Release (TAR), which loosens and stretches a layer of abdominal muscle (the transversus abdominus muscle) in order to cover the weak spot in the abdomen

Why choose Aurora St. Luke’s for abdominal wall reconstruction

The abdominal wall reconstruction program at Aurora St. Luke’s offers unparalleled expertise in the region. When you entrust your care to us, you can expect:

• Expertise: We perform hundreds of complex hernia procedures a year. Of those cases, the majority utilize robotic techniques, which can result in less trauma to the surgical site, fewer complications and shorter recovery periods.
• Experience: Our surgical team consists of surgeons and specialized nurses who perform many of the robotic surgeries at St. Luke’s.
• Comprehensive care: From pretreatment evaluation and imaging to post-op physical therapy and long-term follow-up care, our program is dedicated to ensuring your surgery is a success.

Meet our surgical team

The surgeons on our abdominal wall reconstruction team are highly sought for their deep knowledge of this complex procedure. They’re committed to helping patients through innovative techniques, personalized treatment plans and technical excellence.

• Dr. Nick Armstrong
• Dr. Nan Wu
• Dr. Kelly Novak

Get a second opinion

Abdominal wall reconstruction and complex hernia surgery is highly specialized. As such, our surgical team often receives patient referrals from other surgeons and hospital systems beyond Aurora.

Patients who have known complex or recurrent hernias or whose care teams decline to operate will also seek second opinions for themselves after learning of the expertise at Aurora St. Luke’s. We welcome the opportunity to review your unique situation and help you get the best possible care.

Get a second opinion

Furthering clinical expertise through fellowship

For medical residency graduates, our abdominal wall reconstruction (AWR) fellowship program offers advanced training in preparing current and future physicians to help all people live well.