Abdominal Wall Reconstruction
The Abdominal Wall Reconstruction program, located at CHI Health Creighton University Medical Center in Omaha, Nebraska, is a team of physician specialists and staff members who have the experience and expertise to manage complex abdominal wall defects. The program unites expert surgeons from several specialty areas, including: general surgery, gastrointestinal surgery, surgical oncology, abdominal wall reconstruction and plastic surgery.
What is Abdominal Wall Reconstruction?
The abdominal wall holds in and protects the inner organs of the abdominal cavity (peritoneum). It is made up of several layers of tissue, including skin, fat and connective tissue, muscles, tendons, the peritoneal membrane. When there is a weakness in the tissue or muscle, an organ or other structure can bulge out and cause a lump under the skin. Abdominal wall reconstruction is a complex, comprehensive surgery to correct weaknesses or defects in these many layers. Abdominal wall defects may be the result of a failed prior attempt at closure, recurring hernias, traumatic injury, infection and the effects of radiation therapy or tumor removal. The center also offers options for reconstruction surgery to improve the aesthetic appearance of this region after an initial procedure.
The Abdominal Wall Reconstruction program offers a team of hernia surgeons dedicated to the repair of abdominal wall hernias.
What is a Hernia?
An abdominal wall hernia occurs when the intestine or their surrounding connective tissue (fascia), bulges out through a tear or area of weakness in the abdominal cavity (peritoneum). There are several causes for abdominal wall hernias, but most often they occur at a previous surgical incision site, including a cesarean section (c-section).
Other Types of Hernias
- Femoral hernia is a bulge in the upper thigh, just below the groin. This type is more common in women than men.
- Hiatal hernia occurs in the upper part of the stomach which pushes into the chest.
- Umbilical hernia appears as a bulge around the belly button.
- Inguinal hernia is a bulge in the groin. It is more common in men and may extend into the scrotum.
Correcting a Hernia
Surgery is the only treatment that can permanently repair a hernia, however, if the repair breaks, a specialized procedure for repair should be considered. In some cases, the intestine may become tangled or lodged within a hole in the abdominal wall and cannot be pushed back through, causing the intestine to become strangulated (intestinal ischemia). Intestinal ischemia is a serious condition, and if left untreated, leads to intestinal infarction, meaning the strangulated portion of the intestine dies because it loses its blood supply.
Patients with abdominal cancer often have had multiple surgeries and would benefit from abdominal wall reconstruction. These cancers include:
- Peritoneal Mesothelioma
- Appendix Cancer (Pseudomyxoma peritonei)
- Malignant Melanoma
Abdominal wall surgery also benefits patients who have been treated with Intraperitoneal Heated Chemotherapy (HIPC) following de-bulking surgery to reduce the size of ovarian, pancreatic, colorectal, gastric and liver tumors.
Some patients may develop incision wall hernias or port site hernias associated with the laparoscopic adjustable gastric bands. Many of these patients require hernia repair. Patients who have experienced extreme weight loss following bariatric surgery often develop a large pannus, which is an apron of skin that hangs below the belly button. These individuals often opt for a panniculectomy (tummy tuck) to remove this tissue, for comfort and appearance.
Treatment and Consultation Services
The science of abdominal wall surgery has evolved greatly over the past 10 years. There are now so many surgical methods that it can be difficult for surgeons to determine the best method. The risks and benefits of laparoscopic versus open surgery must be assessed for each patient to ensure the best outcome. The Abdominal Wall Reconstruction program can assume care for patients if the treating physicians prefers. We also welcome the opportunity to provide consultation services to surgeons for patients who would prefer to have surgery in their local hospital, closer to friends and family.
Pioneering the Best Surgical Solutions for Patients
The Abdominal Wall Reconstruction medical team has been involved in developing specific instruments and techniques for the surgical repair of hernias. Additionally, the team conducts ongoing research and clinical trials to further the progress of abdominal wall repair, including closure technologies to reduce pain and infection, and prosthetic materials to provide better support at the surgical site.
For more information about the Abdominal Wall Reconstruction program, or to request a consultation with our medical staff, please call 402-717-4836.