In short
Complexity may result from a large defect, multiple previous operations, recurrence, infection or mesh problems, loss of domain, a stoma or coexisting soft-tissue issues. The goal is a stable abdominal wall with acceptable risk and improved function.
Seek emergency care for sudden severe pain, a hard irreducible hernia, vomiting, fever or abdominal distension.
What happens at the examination
We review previous procedures, symptoms and risk factors and examine the wall at rest and during activity. CT imaging is often used to understand the anatomy and plan possible reconstruction.
- Defect size and location
- Previous mesh and scarring
- Muscle and soft-tissue quality
- Risk–benefit of revision surgery
Treatment options
The most suitable treatment is decided after an individual medical assessment.
After treatment
Major reconstruction requires planned mobilisation, wound surveillance and gradual loading. Time away from work and return to activity are individual.
Related conditions
Frequently asked questions
When is a hernia considered complex?
When size, recurrence, previous mesh, infection, a stoma, soft-tissue problems or the need for advanced muscle mobilisation makes standard repair insufficient.
Can you assess me after several previous operations?
Yes. Previous operation reports and imaging are particularly important for a new assessment.
Is mesh always necessary?
Mesh is often used in major reconstruction to reduce recurrence, but material and position are individual.
Can the wall be closed without excessive pressure?
This is central to planning. Defect size, abdominal volume and tissue mobility are assessed to select a safe strategy.
Will I need to lose weight first?
For some patients, weight loss improves safety and outcomes. Advice depends on symptoms, urgency and overall health.
Can surgery be laparoscopic or robotic?
Minimally invasive surgery suits selected cases, while others need open reconstruction. The method follows anatomy and goals.
What is the recurrence risk?
Risk varies and is higher in complex hernias. Individual technique, optimisation and follow-up aim to reduce it.
What should I bring to the assessment?
Please bring previous operation reports, information about mesh and any CT or other imaging.
Medically reviewed by Dr Elias Tsiolis, specialist in general surgery, senior consultantUpdated 2026-10-25This text does not replace an individual assessment.