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Scottish Hernia Centre

Glasgow’s Premier Private Health Centre

Ross Hall Hospital

221 Crookston Road

Glasgow G12 0PJ

Phone: (0141) 810-3151

Email: info@scottishhernia.com

Contact Details

Scottish Hernia Centre

Glasgow’s Premier Private Hernia Centre

Ross Hall Hospital  Call 0141 810-3151

www.scottishhernia.com

Recurrent Inguinal and Recurrent Incisional Hernia Surgery

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A small number of hernias recur after surgery. The risk of this happening depends the hernia site, how the hernia was repaired and who performed the repair. Experienced surgeons have lower recurrence rates compared to non-specialist surgeons.

The risk of a hernia coming back (developing a recurrence) after surgical repair varies from 1 in 200 (0.5%) to 1 in 7 (15%). The single most important factor is the site of the original hernia. Inguinal hernias have the lowest recurrence rates compared to incisional and femoral hernias which have the highest risk of recurrence.


The risk of developing a recurrent hernia is substantially higher if no mesh was used compared to a repair where a synthetic mesh was used.


The type of surgery that was used to perform the repair is also a factor. The risk of developing a recurrent hernia after an open tension free mesh repair is around 0.5 - 1% compared to a risk of 1-2 % for a laparoscopic or keyhole repair.


The experience of the surgeon performing the surgery is also an important factor and inexperienced surgeons appear to have poorer results compared to experienced surgeons.

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What is a recurrent hernia?

A recurrent hernia is a hernia that reoccurs or reappears in the same place as a previous hernia repair.  

If the swelling appears very near to the scar from the previous repair or operation it is almost never a “new” hernia.

Why do hernias recur?

There are a number of factors that lead to the development of a recurrent hernia. Some of these are avoidable and some not e.g. you cannot avoid an emergency operation for a strangulated hernia. You also do not get to pick the site of your hernia which has an important role in determining your risk for recurrence.


However, you do get to pick your surgeon, which has an important influence on your risk of developing a recurrence.


The most important factors influencing the risk of recurrence are as follows

Should all recurrent hernias be fixed?

Consideration should certainly be given to repairing most recurrent hernias. This is especially so for hernias that are causing symptoms such as pain, impairing mobility or activity.

Small recurrent hernias that are not causing any problems may be observed in patients who are not particularly fit or keen to undergo surgery.

Yes. Richard Molloy undertakes  both open and laparoscopic hernia surgery on a regular basis at the Scottish Hernia Centre, based at Ross Hall hospital Glasgow. He has a particular interest in re-operative  surgery for recurrent hernias.

Ross Hall hospital is Glasgow and Scotland’s premier private hospital, providing state of the art facilities to mange even the most complex hernia problem.

Can I undergo repair of a recurrent hernia at the Scottish Hernia Centre?

How should recurrent hernias be fixed?

The ideal approach to a redo or recurrent hernia repair depends on the nature of the previous repair. Most commonly, patients will have had an open mesh repair. In this circumstance, redo surgery through the old incision can be a very difficult undertaking as all the tissues, nerves and blood vessels are usually pulled into the hernia and scar tissue from the previous repair.


A laparoscopic or keyhole approach in this setting offers the chance to approach the hernia from behind the abdominal wall in “virgin territory” deep to the old operation site. Such an approach means less traumatic and difficult surgery with a faster recovery less prone to complications.

The reverse is also true. Recurrent inguinal hernias following a primary laparoscopic repair are best repaired by an open approach in order to stay away from the scarring at the old operation site.


The same holds true for femoral and umbilical hernias. A laparoscopic approach is not always possible for a recurrent incisional hernia and a clinical decision will be made on the best approach based on site and nature of the previous surgeries.

In general terms, the nature of risks are similar to those for the original operation. Surgery for recurrent hernias is technically more difficult and as a consequence, the risk of developing a complication is higher.

It is also important to remember that there is a small but definite risk of developing a second recurrence after redo surgery for a first time recurrence. The risk relates to how the operation is performed, where the recurrence is situated and who is doing the operation.

What are the risks with redo surgery for a recurrent hernia?