Abdominal Wall Reconstruction Specialist

Why might I need abdominal wall reconstruction?

Abdominal wall reconstruction might be necessary if you have a hernia in the region between your waist and groin. Hernias form when tissues within the abdominal cavity – typically the intestines – protrude through a weakened area of the abdominal wall.

Abdominal wall hernias often form where there are natural weak points, for example, the belly button and groin. They also frequently occur in areas where the abdominal wall is more vulnerable because of previous surgeries.

Open surgery involves making a large incision in the body that carries a 10% chance of resulting in hernia formation because the incised tissues never recover their original strength. Therefore, Dr. Zehnpfennig avoids big, open wounds as much as possible and instead makes much smaller keyhole incisions that pose far less risk of herniation.

Abdominal wall hernias can be painful and limit your physical activity. If the hernia strangulates, the tissues are starved of oxygen and begin to die. That is an emergency that could be life-threatening. Abdominal wall reconstruction can repair the tissues, restoring function and preventing strangulation.

What does abdominal wall reconstruction involve?

The traditional approach to abdominal wall reconstruction involves the surgeon cutting through the already weak abdominal wall. That approach has drawbacks as it could cause further injury and weakening of the tissues.

In the last 20 years, laparoscopic techniques have largely taken over, where surgeons make smaller incisions that are some distance from the hernia. However, this approach has its limitations too.

The surgeon must place a thick piece of coated mesh next to the intestine to strengthen the abdominal wall and reduce the likelihood of the hernia recurring. In some cases, the mesh flips, folds, or moves around within the abdomen, leading to scarring of the bowel followed by infection, enterocutaneous fistula formation (an unnatural opening between the stomach and skin), and recurrent hernias.

Fortunately, Dr. Zehnpfennig of Montana Colon is an expert in using advanced techniques to perform abdominal wall reconstruction that minimizes these risks, including robotic transversus abdominis release (TAR) for large midline hernias and hybrid laparoscopic/robotic extended totally extraperitoneal (eTEP) for complex or recurrent hernias.

What happens when I undergo abdominal wall reconstruction?

Dr. Zehnpfennig specializes in using Intuitive's da Vinci® Xi robotic system to perform abdominal wall reconstruction. The da Vinci surgical robot optimizes the process of repairing your abdominal wall as it gives Dr. Zehnpfennig enhanced dexterity and the clearest visualization of the surgery site.

Controlling the da Vinci robot from his surgeon console, Dr. Zehnpfennig creates a pocket outside your abdomen but within the abdominal wall tissues, where he places the mesh. Dr. Zehnpfennig forms each patient's pocket to fit the mesh precisely, which minimizes the chances of the mesh moving or folding. 

In addition, this approach to abdominal wall reconstruction enables Dr. Zehnpfennig to keep the mesh separate from your intestine, which means he can use Bard™ Soft Mesh, a lighter material that's less likely to move or unravel and is resistant to infection. 

As a result, patients undergoing abdominal wall reconstruction at Montana Colon experience less pain and recover more quickly. Most of Dr. Zehnpfennig's patients go home the same day as their surgery, even for large hernias, and return to work in just a few weeks.

To find out more about the benefits of these advanced approaches to abdominal wall reconstruction, call Montana Colon today or book an appointment online.