Abdominal Wall Reconstruction

Reconstructing the abdominal wall is an intricate surgery, mainly to repair hernias, scars, and damage from prior surgeries. Getting this surgery improves the structure and function of the abdominal walls.

Why would I need abdominal wall reconstruction?

Having a strong abdominal wall is important to protect your organs, support your spine, and help keep you upright. The abdominal wall also helps with various bodily functions like urinating, defecating, or coughing. A compromised abdominal wall can also lead to not feeling full when you eat, which could contribute to weight gain.

In many cases, hernias occur without symptoms, or you may have very few of them—often just a bulge that can enlarge when standing or coughing. However, it’s crucial to attend to the hernia, as it won’t go away on its own.

Most people get abdominal wall reconstructions when previous hernia repair operations haven’t been successful, or have damaged or weakened the wall. Other conditions treated with this kind of surgery include:

  • recurrent hernias
  • managing infections that happen following a surgery
  • attending to a wound that occurs after hernia repair
  • removing cancer
  • managing open wounds in the abdominal wall

What is a hernia?

A hernia happens when an organ ruptures through a weakened area in the muscle or tissue holding it in place. For example, your intestines could break through a weak point in your abdominal wall.

Preparing for an abdominal wall reconstruction

Besides maintaining a healthy diet and getting good exercise, here are some things that will help ensure a smooth process:

  1. Don’t eat/drink 8 hours before your surgery
  2. Smoking affects the body’s healing process. If you smoke, try cut down at least two weeks before the surgery
  3. Let Dr Hatchuel know of any medication you’re taking that affects the blood’s ability to clot. This kind of medicine can cause bleeding complications during or after the procedure.

What does the surgery entail?

You’ll be put under general anaesthetic, with the surgery lasting between two and eight hours, depending on your age, health, and other complications noted before the operation.

Basically what Dr Hatchuel will do is repair the damaged part of the abdominal wall, put the protruding organ back, and then reinforce the compromised abdominal tissue with stitches or a synthetic mesh. The abdominal walls are reshaped by carefully separating the layers of the wall and then putting a piece of surgical mesh behind each layer to fortify the muscles.

He’ll do this as an open surgery, or laparoscopically. A laparoscopy is recommended as it’s less invasive, less risky, there’s less bleeding, and a faster recovery time.

Components Separation Technique

With complex abdominal wall issues like difficult hernias and enterocutaneous fistulas, Dr Hatchuel will use the Components Separation Technique (CST). This technique is used to re-establish abdominal structure and function when there’s not much muscular wall available to pull back together after the removal of a hernia.

Parts of the abdominal wall are cut and lengthened so that separate muscle sections are tension-free and can move well. Then these sections are joined in the middle with sutures and reinforced with mesh, restoring the abdominal muscles.


After the surgery you may feel some pain and discomfort, but it should decrease over time. Dr Hatchuel will prescribe pain medication for you. Gentle activity a few days after the surgery is advised.

About two weeks after the surgery, you’ll have a follow-up appointment to check that you’re healing well. It will take about five weeks to heal, and you’ll be able to return to your regular activities. You can exercise again after about six weeks.