Tampa General Hospital’s Center for Abdominal Wall Surgery and Complex Hernia Repair is a premier destination for patients with the most severe and complex abdominal wall conditions. From the patient’s perspective, choosing our center means choosing a team that specializes in cases others often turn away. We proudly serve as a high-risk referral center, offering hope and advanced care to individuals who have been told, “we can’t help you.” Our goal is to become the largest and most advanced abdominal wall surgery center in the Southeastern United States.
Our team of four expert surgeons, two of whom have specialized expertise in complex differential abdominal wall reconstruction—are all highly trained in managing the most challenging hernia cases. We specialize in minimally invasive and robotic-assisted procedures, including the use of cutting-edge systems like the Hugo and da Vinci robots (the latter currently involved in clinical trials). Our approach addresses a wide range of conditions, including obesity-related hernias, chronic pain, and fistulas. We also offer innovative treatments such as Botox injections to relax the abdominal wall and provide evaluations for patients who have undergone multiple failed hernia repairs.
What sets us apart is not only our surgical expertise but also our commitment to personalized, multidisciplinary care. We accept referrals from community physicians, surgeons, and surgical oncologists, and also welcome self-referred patients. Our center is deeply involved in research and academic contributions, continuously advancing the field through publications and clinical trials.
About Hernias and Other Abdominal Wall Conditions
Composed of multiple layers of skin, fat, fascia and muscle, the abdominal wall serves as a protective barrier for the abdominal cavity while supporting essential bodily functions. Hernias and other abdominal wall conditions occur when structural weaknesses or defects develop within this complex structure, potentially compromising its integrity and function.
Hernia is the most common abdominal wall condition, occurring when a tissue or organ, such as the small or large intestine, protrudes through a weakened area or opening in the abdominal wall. Hernias can vary in severity, with more serious cases requiring urgent medical attention, especially if the herniated tissue becomes trapped or its blood supply is compromised.
Abdominal wall conditions can have a variety of causes and contributing factors, including:
- Aging – Over time, the muscles and other tissues in the abdominal wall may naturally weaken, increasing the likelihood of herniation.
- Chronic constipation or coughing – Often associated with straining, frequent constipation and coughing can contribute to hernia development.
- Excessive intra-abdominal pressure – Activities that involve straining, such as heavy lifting, can increase the pressure within the abdominal cavity, potentially weakening its wall.
- Genetic predisposition – A family history of hernias or weak connective tissue may elevate the risk of abdominal wall defects.
- Obesity – Carrying excess body weight can increase the pressure on the abdominal wall.
- Pregnancy – The physical strain of pregnancy, particularly in the late stages, can weaken the abdominal wall or separate the abdominal muscles (diastasis recti).
- Prior abdominal surgery – Scar tissue may form after a surgical procedure, making the patient more prone to hernia and fistula development.
- Tobacco use – Smoking can lead to chronic coughing and tissue weakening, increasing the risk of hernias.
- Trauma – A direct blow to the abdomen can damage the abdominal wall.
Why Choose TGH
Multidisciplinary Approach to Care
The multidisciplinary team in TGH’s Center for Abdominal Wall Surgery and Complex Hernia Repair includes numerous specialists who share the sole purpose of ensuring a positive surgical outcome for each patient. As needed, we collaborate closely with experts in other medical disciplines, including anesthesia, bariatric surgery, colorectal surgery, nutrition, pain management, physical therapy, plastic surgery, radiology, surgical oncology and urology. In this way, we provide comprehensive, personalized care.
Abdominal Core Health Quality Collaborative (ACHQC) Membership
Our center is dedicated to delivering the most advanced, evidence-based hernia repair treatments. As part of this commitment, we are proud members of the Abdominal Core Health Quality Collaborative (ACHQC), a non-profit research organization that collects and analyzes data on hernia repairs and abdominal core health outcomes. By collaborating with academic medical centers nationwide, ACHQC uses this data to drive research that informs and enhances future surgical practices. Our physicians actively contribute to this field, having published hernia-focused research in respected peer-reviewed journals.
Advanced Surgical Technology
TGH’s Center for Abdominal Wall Surgery and Complex Hernia Repair is committed to utilizing and incorporating the most advanced surgical techniques and technologies available today. One example is the da Vinci Surgical System, a state-of-the-art robotic-assisted surgical platform designed to enhance the surgeon’s precision, control and visualization during minimally invasive surgery. Developed by Intuitive Surgical, this advanced system allows our surgeons to perform complex procedures with the assistance of a console-controlled robotic system equipped with miniaturized instruments and a high-definition, three-dimensional (3D) camera. The da Vinci System translates the surgeon’s natural hand movements into precisely scaled movements of thin robotic arms, which can bend and rotate beyond the capabilities of the human hand. This technology enables smaller incisions, less blood loss and a faster recovery compared to traditional open surgery.
Expert Surgeons
Advanced surgical technologies, such as robotic-assisted systems, are revolutionizing the field of surgery. However, in terms of optimizing the surgical outcome, the true difference lies in the skill and expertise of the surgeon behind the robotic console. No technology can replace the critical decision-making, refined technique and in-depth experience that a highly trained surgeon brings to the operating room. At TGH, our specialists combine cutting-edge technology with advanced surgical proficiency to ensure the best possible outcome and quality of life for every patient we treat.
Our Team
Conditions Treated
The multidisciplinary team in TGH’s Center for Abdominal Wall Surgery and Complex Hernia Repair offers the latest treatment options for all types of hernias, including:
- Diaphragmatic hernia – A defect in the diaphragm allows the abdominal organs to migrate into the chest cavity, potentially affecting breathing. Hiatal hernia is a type of diaphragmatic hernia.
- Enterocutaneous fistula with hernia – An abnormal connection forms between the small or large intestine and the skin, often within a hernia sac.
- Incarcerated hernia – Fatty tissue or a section of the small or large intestine becomes trapped within a hernia sac and cannot be pushed back into place.
- Incisional hernia – A hernia develops at the site of a previous surgical incision due to weakened abdominal muscles.
- Incisional hernia with fistula formation – A hernia and fistula form at a surgical incision site.
- Inguinal hernia – A bodily tissue or organ protrudes through a weak spot in the lower abdominal wall, creating a bulge in the groin area.
- Lumbar, obturator and flank hernias – Tissue pushes through the abdominal wall in the lower back, pelvis or side of the abdomen.
- Obesity with hernia – A hernia develops in an individual with a body mass index (BMI) of 30 or higher, which can make surgical repair more challenging and raise the risk of recurrence.
- Parastomal hernia with fistula – A hernia forms around a stoma, leading to the development of a fistula.
- Recurrent hernia – A hernia redevelops after surgical repair.
- Spigelian hernia – A hernia occurs along the Spigelian fascia, a weak transition point in the lower abdominal wall where muscle fibers give way to connective tissues.
- Strangulated hernia – After fatty tissue or a portion of the small or large intestine becomes trapped within a hernia sac, blood flow to the trapped tissue is restricted, potentially leading to tissue death (a medical emergency).
- Umbilical hernia – Part of the small or large intestine presses through a weak spot in the abdominal muscles near the navel.
- Ventral hernia – A hernia develops at the front of the abdominal wall (belly area), such as an incisional or umbilical hernia.
In addition to hernias, we treat other abdominal wall conditions, including:
- Chronic pain in the groin or abdominal wall after hernia repair – Due to nerve irritation or scar tissue formation, persistent pain may develop after hernia surgery.
- Diastasis rectus – The abdominal muscles can separate along the midline after pregnancy or a significant change in body weight.
Treatment Options
The experienced surgeons in TGH’s Center for Abdominal Wall Surgery and Complex Hernia Repair have undergone extensive training in complex hernia repair, with some having completed advanced fellowships in abdominal wall reconstruction. These highly skilled professionals perform the latest techniques in abdominal wall surgery, utilizing robotic-assisted, laparoscopic, open, component separation and extended totally extraperitoneal repair (eTEP) approaches as appropriate.
Our multidisciplinary team can also assist patients who are living with chronic pain stemming from prior hernia surgery. Our pain management options range from conservative therapies, such as medications, nerve injections and Botox® to relax the abdominal wall, to surgical interventions, such as nerve resections.
Support Services
In addition to providing the most advanced surgical approaches to hernia treatment, TGH’s Center for Abdominal Wall Surgery and Complex Hernia Repair offers a full range of supportive care services. We thoroughly evaluate each patient’s medical history, surgical history, imaging scans, post-operative goals and need for preoperative optimization and postoperative recovery services before developing a tailored care plan.
The first step toward a successful surgical outcome is ensuring the patient is in the best possible health before the procedure. To that end, we offer comprehensive preoperative optimization services, including:
- Cardiopulmonary optimization – Evaluations and interventions to improve heart and lung function, which is especially important for patients with preexisting cardiovascular conditions
- Diabetes and blood sugar control – Monitoring and optimizing glucose levels to minimize infection risk and support wound healing
- Medical evaluation and risk assessment – A comprehensive health assessment to identify and address any underlying conditions that could affect the surgery
- Medication management – Adjustments to medications, such as temporarily stopping drugs that may impact bleeding, immune response or anesthesia tolerance
- Nutritional counseling – Individualized guidance on a balanced diet to promote healing, strengthen the immune system and manage weight
- Patient education and surgical preparation – Information about the procedure, postoperative care and recovery expectations
- Physical conditioning and core strengthening – Prehabilitation exercises to enhance strength, flexibility and overall fitness before surgery
- Preoperative imaging and diagnostics – Tests such as computed tomography (CT), ultrasound and magnetic resonance imaging (MRI) scans to help the surgeon assess the hernia and surrounding structures
- Psychological support and counseling – Resources to help manage anxiety, stress and concerns about surgery and recovery
- Smoking cessation support – Programs to help the patient quit smoking, which is essential when preparing for surgery because tobacco use can impair healing and increase surgical risks
- Weight management programs – Assistance with achieving a healthy body weight to reduce strain on the abdominal wall and improve the surgical outcome
Likewise, our postoperative recovery services are designed to ease the healing process and reduce the risk of surgical complications. These include:
- Activity modification guidance – Instructions on lifting restrictions, movement limitations and gradual return to normal activities
- Drain and suture removal – Follow-up care to remove surgical drains or sutures as needed
- Follow-up appointments – Regular visits with the surgeon to monitor progress and address any concerns
- Infection prevention and monitoring – Assessment for signs of infection or complications, such as fever, swelling and drainage
- Hernia prevention education – Guidance on lifestyle changes, such as weight management and core strengthening, to reduce the risk of hernia recurrence
- Nutritional support – Dietary recommendations to aid recovery and promote healthy weight management
- Pain management – Medications and therapies to control discomfort and support healing
- Physical therapy – Guided exercises to restore mobility, strengthen the core and prevent complications
- Supportive wear – Compression garments and abdominal binders to reduce swelling and enhance healing
- Wound care – Incision monitoring and dressing changes to prevent infection and ensure proper healing
Research and Clinical Trials
The scientists and clinicians in TGH’s Center for Abdominal Wall Surgery and Complex Hernia Repair are committed to advancing the field through extensive research and clinical trials. We actively participate in studies aimed at improving surgical techniques, optimizing patient outcomes and reducing complications associated with complex hernia repair and abdominal wall surgery.
Our current research efforts are focused on key areas such as advanced robotic-assisted procedures, biologic and synthetic mesh materials and strategies for minimizing hernia recurrence rates in high-risk patients. We also collaborate with national and international research networks to evaluate new treatment approaches, enhance postoperative recovery protocols and refine best practices in abdominal wall reconstruction. Through these important initiatives, TGH remains at the forefront of surgical innovation, providing patients with access to the most up-to-date, evidence-based treatment options for hernias and other abdominal wall conditions.
In recent years, medical advancements have led to steady improvements in hernia repair outcomes for nonobese patients. However, the rising prevalence of obesity has resulted in a growing number of hernia patients who face additional surgical risks. To address these challenges, TGH’s Center for Abdominal Wall Surgery and Complex Hernia Repair offers a staged treatment approach in collaboration with the TGH+USF Health Bariatric Center. This innovative strategy begins with bariatric surgery to support significant weight loss. Once the patient achieves their weight loss goals—typically within six to 12 months—they proceed with complex hernia repair, potentially improving both the surgical outcome and long-term recovery.