• A hernia becomes complex when repeated surgical attempts fail to repair it.
• When a hernia repair operation breaks down (i.e. a 'recurrent' hernia) further repair operations are more difficult than the first and, to make matters worse, the chances of success actually diminish with each successive attempt at repair.
• The same is true of the breakdown of the scar in the abdominal wall from an incision for a previous operation for some other problem. This is called an 'incisional' hernia.
• Thus the 'recurrent' hernia and the 'incisional' hernia are very similar in many respects, including the difficulties in effecting a reliable repair.
• Unfortunately, there are also cases of 'multiple hernias' and of combinations of all the above, such as 'multiple, RECURRENT hernias'. These cases pose many difficulties to most surgeons and are, all too often, not successfully repaired.
• Complicated/complex hernias include those that have either been repaired before on multiple occasions, those associated with infections, or those that have resulted in bowel perforations or fistulas. Each of these hernias poses their own unique challenge.