General Surgery

University of Maryland Hernia Center

Hernia Center | Laparoscopic Hernia Repair | Dr. Scott Roth Q&A | Sports Hernias | Complex Hernias

Complex/Complicated Hernias

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Get answers to your hernia related questions by e-mailing Dr. Scott Roth.

Note: This is for informational purposes only. Doctors cannot provide a diagnosis via e-mail.

The University of Maryland Hernia Center sees patients from all over world with complicated/complex hernias. We treat these types of patients on a daily basis and give them the individualized attention they need. Most importantly, all treatments are tailored to meet the needs of each patient.

Complicated/complex hernias include those that have either been repaired before on multiple occasions, those associated with infections, or those that have resulted in bowel perforations or fistulas. Each of these hernias poses their own unique challenge.

In the presence of ongoing infection or contamination, synthetic meshes should be avoided. In these cases, Dr. Scott Roth, director of the Maryland Hernia Center, recommends the repair of the hernia with a patient's own tissues if possible. “A separation of components technique will allow the muscles of the abdominal wall to be advanced to close a defect,” he says. “In many cases, hernias as large as 20 centimeters may be closed with this technique.”

Hernias that are not amenable to this technique may be repaired with biologic meshes. These meshes, derived from either human or animal materials, may be used. The advantage of biologic meshes is related to their resistance of infection. These materials may be safely used in patients with active infections and can avoid the need to use a synthetic mesh that could become infected. Synthetic meshes should be avoided in patients with ongoing infection or contamination with bacteria.

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Recurrent hernias may also be a significant challenge due to the placement of prior mesh and adhesions between the abdominal wall and intestines. Many recurrent hernias patients will have weakened abdominal wall tissues that do not hold sutures well.

Techniques for repair of these hernias may involve placement of a single large sheet of synthetic mesh to repair the entire abdominal wall, utilization of the patient’s native tissues by means of separation of components technique, or the use of biomaterials which may serve as a matrix for tissue regeneration.

Diagnosing and treating complex hernias is one of the many specialties of the University of Maryland Hernia Center. Led by Dr. Roth, the Maryland Hernia Center is considered one of the nation’s leaders in minimally invasive hernia repair surgery, including the repair of recurrent hernias.

For more information about the University of Maryland Hernia Center or to make an appointment, please call 410-328-6187.

This page was last updated on: April 9, 2008.

If you would like to make an appointment or talk to someone about our services, please call 1-800-492-5538 (patients) or 1-800-373-4111 (physicians).