In short
Advanced abdominal wall surgery includes large or recurrent incisional hernias, multiple defects, hernia combined with rectus diastasis and situations where the abdominal wall muscles need to be mobilised and reconstructed.
Seek emergency care if a hernia suddenly becomes hard, severely painful and cannot be reduced, particularly with nausea, vomiting, fever or abdominal distension.
What happens at the examination
The assessment includes previous operation reports, examination of the entire abdominal wall and often review of CT imaging. We consider defect size, muscle quality, existing mesh, skin and soft tissue, and factors affecting healing and recurrence.
- Review of previous surgery
- Whole-wall assessment
- Imaging review
- Individual reconstruction plan
Treatment options
The most suitable treatment is decided after an individual medical assessment.
After treatment
Major abdominal wall reconstruction requires planned pain relief, wound surveillance and a gradual return to loading. Follow-up is tailored to the extent of surgery.
Related conditions
Frequently asked questions
What makes a hernia complex?
It may be a large or recurrent incisional hernia, multiple defects, major tissue loss, previous mesh problems or a hernia requiring advanced reconstruction to close the abdominal wall.
Will I need a CT scan?
Often for larger or previously operated hernias. Imaging maps the defect, muscles, contents and previous mesh before planning.
Can a failed previous repair be revised?
Yes. Recurrent hernias can be assessed for revision, with the method adapted to previous incisions, mesh, scar tissue and the reason for recurrence.
What is component separation?
It is a group of techniques that release abdominal wall muscle layers so they can move towards the midline when closing larger defects.
Do all complex hernias require surgery?
No. Expected benefit is weighed against symptoms, risk, health and the likelihood of a durable reconstruction.
Where does surgery take place?
Assessment and follow-up take place in Karlstad. The operating setting is planned according to the scale and resources required.
How long is recovery?
Recovery is longer than after minor hernia surgery and depends on the extent of reconstruction. You receive an individual activity plan.
How is recurrence risk reduced?
Careful planning, appropriate mesh placement and optimisation of smoking, weight, blood glucose and nutrition are important.
Medically reviewed by Dr Elias Tsiolis, specialist in general surgery, senior consultantUpdated 2026-10-25This text does not replace an individual assessment.