Is there a high probability of recurrence after surgery for a hernia?

I underwent a hernia surgery: is it possible to quantify the risk of recurrence in the next few years? I know there is a possibility that the hernia will come back and I would like to understand in which cases this can happen.

He answers Giampiero Campanelli, full professor of Surgery at the University of Insubria; Director of General Surgery and Hernia Center at the Sant’Ambrogio Clinical Institute in Milan; editor in chief Hernia JournalSpringer-Nature (GO TO THE FORUM)

Abdominal wall hernia surgery has achieved an excellent level of specialization and results in expert hands. There conditio the profound anatomical knowledge, the extensive culture of new materials, constant and updated scientific activity and a great numerical experience of simple and complex cases relating to all techniques (open, laparoscopic and robotic) and to different types of patients are essential. Only by respecting this absolute condition can we guarantee the patient and the individual clinical case excellent results. Which means one very low incidence of relapses and complications, such as pain, which in the case studies of real specialists reach percentages close to zero. It has now become clear that relapses and complications are due to a combination of the surgeon’s experience and the patient’s characteristics of anatomical normality or not. We said, and to answer the reader, it is important to first do a necessary distinction between abdominal wall herniaswhich include for example the epigastric and the umbilical (accompanied or not by diastasis), Spigelian hernia and lumbar hernias give her hernias of the inguino-crural regionsuch as the inguinal hernia and the crural hernia.

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The incidence of the latter (inguinal and crural) is much higher than hernias of the abdominal wall: it reaches about 150,000 surgical procedures per year, compared to 30,000 for the abdominal wall. The large number of interventions per year therefore justifies the considerable epidemiological impact. The assessment of relapses implies that the operated subject has been treated in a center of excellence that mandatorily provides for remote controls, the so-called follow up. The latter, serious and reproducible, on the one hand justifies and endorses or not the techniques used over a long period and on the other hand qualifies the surgical center. The reported results should be published in high impact scientific journals and with a proven anonymous review of the texts and data by scientists recognized by the international scientific community (the so-called peer review): verbal references, texts disseminated via internet sites or statements that cannot be demonstrated in non-scientific journals are therefore not enough.

Relapses after 5 years

In a recent article published in the journal JAMA (Journal of the American Medical Association), by the group of Dana Telem (collaborator of the scientific journal HERNIA – Springer Naturedirected by us), are published data of a very extensive review that highlights for abdominal hernias, considered as a whole, a percentage between 10 and 12 percent of relapses after 5 years, with a slightly significant difference in favor of open repair versus laparoscopy. The data is not striking and is in line with that of our most serious national and international cases. Basically, it is possible to state, by replying to the reader, that, in regards to hernias of the anterior wall of the abdomen, the distant recurrence rate varies between 1 and 12 percent, depending on the experience of the surgical center and the individual surgeon, with the same patient as normal. With regard to inguinal herniasthis percentage ranges from 1 to 20 percent, again on the basis of the aforementioned peculiarities.