Conditions

Mr Charles Imber offers expert abdominal surgery. The operations that he performs can treat a variety of conditions that affect the organs inside the abdomen (pancreas, gallbladder, liver, spleen, small and large intestine) or the abdominal wall (hernias).

If you know what condition you want to find out more about, use the search option below. Alternatively, browse our database using the menu on the right.

Complex abdominal hernias

While many abdominal hernias are simple and easily treated with an open/laparoscopic hernia repair, a few are more complex. They include:

Incisional hernias in which the intestine pushes through a body wall weakened by previous hernia surgery, sometimes in several places. In some incisional hernias, the original wound has only partially healed. Some of the intestine can become trapped in the scar tissue

Strangulated hernias

  • 1Very large hernias that are due to general weakness in the abdominal wall, making standard repair techniques difficult
  • 2Hernias that recur repeatedly despite surgical repair
  • 3Infected hernias, including infection in the region of a hernia repair
  • 4Infection in the mesh used to repair some larger hernias
  • 5Complex infected wounds with fistulae: the intestine ruptures and releases the contents of the bowel into the wound, which gets larger and will not heal.

Many of the more serious types of complex abdominal hernia were inoperable only a few years ago. The only treatment available for a large and complex hernia was to wear a supportive medical corset to hold the internal organs in place.

Now we have new techniques and technologies that make it possible to not only repair the hernia and prevent it from recurring again, but the tissues that have been damaged can also be reconstructed.

Living with a complex hernia

If someone with a complex hernia does not have access to a specialist surgeon with experience in treating difficult cases, they may lose much of their quality of life.

Complex hernias can be very painful but they are also disfiguring, embarrassing and restrict movement and everyday activities. Not only are you often not able to work, go out or see your family, having any sort of social life becomes difficult.

Treatment challenges in complex hernias

  • 1Large hernias: small hernias are easy to repair using the body’s own tissues to strengthen the underlying weakness in the muscles of the body wall. Surgical or biological mesh needs to be used to repair larger hernias, particularly if the patient is overweight or obese.
  • 2Strangulated hernias: once a hernia lump becomes trapped in the body wall, it can become inflamed and infected. Repairing the hernia also means removing the part of the intestine that has been damaged and joining up the healthy ends.
  • 3Infected incisional hernias: any complex hernia in which there is a chronic infection poses a great challenge for surgical repair. There is a danger that the infection will spread into the rest of the body through the blood, and a risk that any surgical mesh that is used will become the site of a local infection.
  • 4Infection in a hernia mesh repair: again there is a risk of spreading the infection, but an infected mesh needs to be removed and cannot be replaced by new synthetic mesh. Reconstructive surgery to repair the body wall using the patient’s own tissues and the use of more expensive biological meshes is then needed as they are more resistant to future infection.
symptoms
A lump in the abdomen or groin that is very large and/or very painful.
Fever, nausea, vomiting and generally feeling unwell.
Feeling bloated and being unable to pass stools: this is a danger sign of a bowel obstruction.
diagnosis
Complex hernias are best assessed by a specialist surgeon with experience in treating complex hernia cases.
treatments
Laparoscopic hernia repair using a surgical or biological mesh.
Open hernia repair using a surgical or biological mesh.
Reconstructive surgery using component separation techniques and other plastic surgery methods.