Can a hernia come back after surgery? The short answer is that it depends. The long answer depends on what? Hernia repair is an operation where we try to recreate the weak abdominal wall using reconstruction of the muscles and also using a mesh. However, the final success of the operation depends on multiple factors. This is because when the healing is good, the scar is healthy, and when the scar is healthy, the hernia does not come back.
Key Factors Influencing the Success of Hernia Surgery
How well a hernia surgery works depends on different things. While some factors depend on the patient, others depend on the kind of treatment they get.
What are the Patient-Related Factors?
- Diabetes
In patients with high blood sugar levels, tissue quality is poor. Their healing is not on par with individuals who do not have diabetes. If they do not have good sugar control, the scar tissue that forms is going to be weak, and patients with diabetes can have a higher rate of failure of hernia operations in the long run if they do not maintain good sugar control.
- Obesity
In patients who are extremely obese, their muscle mass is thinner, or if the patient gains a lot of weight following a hernia repair because of excessive stretching, the scar tissue is pulled and stretched, and thereby the hernia repair can give way.
- Smoking
The body scar can be referred to as cement. The cement that the body produces to heal any wound. The quality of that cement or collagen is directly affected by smoking. If the patient continues to smoke after hernia repair, the quality of the scar is very poor, and the hernia can come back again.
- Previous Radiation Therapy
If the patient has received radiation for any sort of cancer, the tissues are generally damaged by the radiation. This increases the risk of hernia recurrence.
- Other Factors
There are other factors, like patients who have chronic severe coughing or who do very strenuous activities very early after the hernia operation. These patients can have a weakening of the scar.
What are the Treatment-Related Factors?
What sort of treatment was done? What is the experience of the surgeon? What is the technique that was used for hernia repair? Was the technique appropriate for that type of hernia? Certain hernias are best treated laparoscopically, and certain hernias are best treated by open surgery. If the surgeon chooses the right operation for the right patient, the chance of success is very high. Was mesh used to reinforce hernias or not? If so, what sort of mesh has been used?
These are all factors that will contribute to the final result of whether the hernia is going to be cured forever or whether it will come back after a few years. There is no simple answer to this question: if I do a hernia repair now, will it come back again? It depends on so many of these factors, and that will be individualized. Generally, we usually discuss this with the patient before surgery, where we assess all these factors and give them a rough estimate of the chance of success of the hernia operation.
