Abdominal wall reconstruction for large ventral abdominal hernia 

Before Your Surgery

• Authorization should be obtained prior to surgery and will be done by the hospital or the rooms staff depending on whether you are an in- or outpatient.

• Make sure that you have been fasting for solid foods for at least 6 hours prior to your surgery and for clear liquids or water for at least 2 hours prior to your surgery. Discuss your chronic medications with your doctor or hospital staff prior to your surgery as you usually are allowed to take chronic medications the day of surgery, barring diabetic medication the day of the procedure. If you are taking any blood thinning medication please discuss these in detail with your doctor as special arrangements need to be made for these.

• Weight optimisation, smoking cessation, diabetic control, nutritional optimisation, blood tests, CT imaging, and anaesthetic assessment may be required before surgery.

Day of Surgery

You will be admitted to hospital and taken to theatre. After surgery, you may be monitored in recovery, high care, or ICU depending on the complexity of the operation and your medical condition.

You may have intravenous drips, a urinary catheter, wound drains, dressings, and an abdominal binder.

Procedure

The procedure is performed under general anaesthesia. It may be performed laparoscopically (in smaller cases) or open. Especially when large and complicated.

The hernia sac is opened, and the abdominal contents are carefully freed from scar tissue and returned to the abdominal cavity. The abdominal wall is then reconstructed using advanced techniques, which may include:

• Release of abdominal wall muscle layers to allow closure without tension

• Component separation

• Placement of surgical mesh to reinforce the repair

• Removal of excess or damaged skin if required

• Drain placement to reduce fluid collection

The aim is to close the abdominal wall safely, restore function, and reduce the risk of recurrence.

Procedure Length

The procedure usually takes 3–6 hours, depending on the size of the hernia, previous surgeries, scar tissue, and complexity of the reconstruction.

Possible Complications

• Possible complications include bleeding, infection, seroma or haematoma formation, wound breakdown, skin loss, mesh infection, bowel injury, bowel obstruction, respiratory complications, chronic pain, recurrence of the hernia, need for ICU care, and unintended damage to surrounding structures.

Duration of Hospital Stay

• ​Hospital stay is usually 5–10 days, but may be longer in complex cases, especially if ICU care, wound care, or delayed bowel function occurs.