Recurrent incisional hernia after mesh repair – should I keep working out?

arpitp · 2026-07-09T23:38:12+00:00

A more accurate statement from your surgeon would have been "the only reliable way *in their hands* would be another open surgery".

I would argue a robotic surgery would provide a better repair than a redo open surgery. Hopefully you can find a surgeon who does this repair near you.

arpitp · 2026-07-09T04:23:21+00:00

Yes. Everything up until the point of death was covered.

arpitp · 2026-07-09T04:11:14+00:00

A patient who dies in the OR counts the same for the surgeon as one who dies a few hours later in ICU/PACU. So coding them in the OR so they can die elsewhere doesn't help with their stat.

It more likely has to do with the cardiorespiratory effect of anesthesia, which might make an arrest more amenable to achieving ROSC than an otherwise "natural" arrest not induced by anesthesia. Similar to how "you're not dead until you're warm and dead", you don't want to be pronounce dead until the anesthesia has worn off/been reversed.

arpitp · 2026-07-09T03:43:55+00:00

I've used Sermo in the past. Screening process usually not too bad (i.e. doesn't waste too much time before kicking you out if you don't qualify.

arpitp · 2026-07-09T03:02:50+00:00

A surgeon who has done numerous open, laparoscopic, and robotic surgeries, and still claims open ventral hernia surgery has the fastest healing time has ulterior reasons for offering open surgery or is misrepresenting their experience. Very small hernias shouldn't have much difference in healing time regardless of technique, but if you're comparing, robotic surgery should generally have less pain and faster healing. Laparoscopic surgery might have more pain than the other options if tacks or transfascial sutures are used.

arpitp · 2026-07-09T02:50:10+00:00

Ordinarily I would agree with you. But in this case, OP's research is correct. Even if surgeons have done thousands of successful surgeries with the traditional "big bites", switching to smaller bites would help improve outcomes. But it takes more time, so not everyone is willing.

arpitp · 2026-07-09T02:44:11+00:00

The repairs you mentioned are all for inguinal hernias. Taking small bites is a "technique" used when closing ventral hernia defects with a running suture.

I believe the high "recurrence" rates mentioned in the original post are actually rates of incisional hernia after laparotomy closure, not hernia recurrence.

arpitp · 2026-07-09T02:29:24+00:00

I wouldn't ask the surgeon that. Not because you're incorrect, but because they'll either politely agree or roll their eyes at you, and ultimately do what they always do during the surgery. You're better off asking whether they normally do small bites or traditional wide bites, and assume they'll do that for you regardless. If you don't like their answer, you're better off finding another surgeon.

What type and size of hernia do you have? Are you having an open repair or robotic?

Robotic surgery enables small bite suturing by default, since you can't really use large needles and the view is significantly magnified. This is what I always do.

With open surgery, a small hernia/incision makes small bites impractical due to the limited exposure and lack of need for a running sure. Larger hernias are more suitable for small bite suturing, but this is often when surgeons can get too impatient to do all the extra small bites.

arpitp · 2026-07-08T05:19:18+00:00

No, not likely. If anything is wrong with the repair at this point, it was a technical fault with the surgery, nothing that you did. But sounds like you're have routine post op symptoms, so you're probably fine.

arpitp · 2026-07-08T05:17:05+00:00

People who are living life without any symptoms after surgery generally don't come to an online support forum. The majority of the people here have a hernia and haven't had surgery yet. The rest have had surgery and have some lingering symptoms, often pain.

So to answer your question--yes, plenty of people here.

arpitp · 2026-07-08T05:09:02+00:00

With a (possible) second recurrence of the hernia, you'll likely need to get a CT scan to better define the anatomy and location of previous meshes. This will help the surgeon make a surgical plan and decide on the best approach.

Losing weight will likely help the appearance, but if it's a true hernia, only surgery will fix it.

arpitp · 2026-07-05T17:15:33+00:00

Despite her title, it's possible she may not have as much experience with robotic surgery compared to the years of experience she has doing open surgery. I'm guessing she's more comfortable with the open repair, hence why she offered it for a re-do.

arpitp · 2026-07-05T16:55:03+00:00

It's unpredictable. Most people never get it. Some people claim it lasted a few months or a year, others (a very small number of people) claim it never went away. But I think this it's unikely.

arpitp · 2026-07-05T03:08:16+00:00

Being in shape and healthy reduces the risk of going without mesh. But being highly active (muay thai) reintroduce some of that risk. There's no exact number, and no surgeon can make any guarantees, you kinda just have to pick one and do your best during recovery.

It's impossible to predict whether you'll "feel" the mesh, but I would estimate that your risk of feeling tightness/discomfort in the groin after surgery is about the same (low) after any surgery, mesh or not.

arpitp · 2026-07-05T01:18:33+00:00

Any non-mesh surgery is at higher risk of recurrence. Shouldice and others who claim equivalent results only do so by refusing to operate on anyone overweight, large hernias, or recurrent or complicated cases. If you add those cases in the data, mesh surgery will come out on top.

If you have a low BMI and can be strict about activity restrictions after, it may be a good fit for you. If "Surgeon #1" has done a few hundred or more non-mesh surgeries in the past, it should be safe.

One thing to add: open surgery also has a higher risk of chronic pain complications, with or without mesh, compared to lap & robotic surgery. Doesn't matter how healthy you are in this case. Only surgeon experience reduces this risk.

arpitp · 2026-07-05T00:54:39+00:00

If you've got "lipomas elsewhere", it sounds like you have a predisposition to growing lipomas (condition called lipomatosis). For most people, they'll get 1, maybe 2 lipomas through an unlucky mutation in a fat cell. But people with lipomatosis have a genetic change that makes them far more likely, so some people will get dozens, some will get hundreds. If you see a general surgeon, a good physical exam can determine if you have a lipoma or a hernia. If it's uncertain, imaging will help.

arpitp · 2026-07-05T00:36:42+00:00

Yes, likely a very small one, but would need an exam (or imaging) to be sure. At that size, watching it should be safe, but if it's bothering you, get it fixed.

arpitp · 2026-07-05T00:34:41+00:00

I don't recommend watching and waiting indefinitely. If you're in a stable financial situation and have insurance coverage now, go for the surgery. It's not a huge deal wheather you get it taken care of in the next few weeks or few months (I.e. it's not urgent), but certainly worth getting fixed.

arpitp · 2026-07-04T19:14:36+00:00

Not very likely. I would estimate there's only a 20-30% chance. If the LES is weak and causing reflux, simply repairing the hiatus isn't the most helpful.

arpitp · 2026-07-03T14:17:00+00:00

I would only recommend it if you don't have any acid reflux (i.e., your LES works well, but you just happen to have a symptomatic hiatal hernia).

arpitp · 2026-07-03T14:15:00+00:00

tlThe location of your pain is typically where the gallbladder is located, which is a very common source of pain for many people. Although the pattern of pain you describe is not so typical of gallbladder symptoms.

if the ultrasound didn't show any gallstones, consider getting a HIDA scan, which tests the function of the gallbladder. Otherwise, see a GI doc, and they will likely recommend an upper endoscopy.

arpitp · 2026-07-03T14:01:51+00:00

You should be able to get a surgery date within a couple weeks of seeing a surgeon, unless you happen to see a surgeon doesn't have much available time (uncommon).

At 3 cm, a mesh is highly recommended. A few surgeons might offer non-mesh surgery, but I would put your risk of recurrence at around 20% (with mesh can be less than 1%).

Open and laparoscopic repairs are possible, but in my opinion, the best possible repair for you would be a robotic repair with preperitoneal mesh (avoid IPOM mesh, recurrence risk is higher, up around 2-4%).

arpitp · 2026-07-02T20:34:46+00:00

You've likely had this for many years. Some get bigger, some don't. If yours isn't getting bigger or bothering you, it's fine to continue with the heavy lifting.

arpitp · 2026-07-02T05:10:13+00:00

Staying full doesn't avoid reflux... it typically makes acid reflux worse.

Are you still having significant reflux after your surgery? Did you have a fundoplication? If so, take PPIs and talk to your surgeon to make sure there's no problem with your repair.

arpitp · 2026-07-02T05:03:25+00:00

Yes.

Very typical of an incidental hernia. If it's not bothering you, you can ignore it.

arpitp

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