Abdominal Wall Reconstruction Service

The service is for patients who have a Complex Abdominal Wall Hernia (CAWH). The service is provided by the York Abdominal Wall Unit (YAWU) which consists of two gastrointestinal surgeons, two plastic surgeons, dietician, a research fellow and secretary.

The service comprises of many stages in the pathway. At each stage of the pathway through the service, different professionals will see you.

Patients referred for Complex Abdominal Wall Reconstruction (CAWR) are first seen in a specialist abdominal wall hernia clinic where you see a consultant gastrointestinal surgeon and a consultant plastic surgeon.  You may be referred to see a dietician in the clinic, and management plans will be made.

The different stages of the CAWR service are shown here and listed below:

• Referrals management – referrals team manage your referral.
• Process prior to clinic – the team will prepare any documentation before your admission.
• Clinic management – The clinic will manage and schedule your appointment.
• CT – doing a CT scan (CT stands for Computerised Tomography which uses x-rays to create three dimensional pictures to look at the hernia and abdominal wall).
• Pre-optimisation – a set of measures and advice to make you fitter for an operation including advice about smoking, weight loss, dietary habit, exercise etc.
• Preoperative adjuncts – sometimes we use botox injections into the abdominal wall to help us operate on the abdominal wall and close the defect without tension.
• Preoperative planning – the general surgeon and plastic surgeon will meet to plan the operation details, we also plan the perioperative assessment and care.
• On the morning of surgery – we confirm details and mark the hernia and record your consent for the operation
• Surgery – the actual operation that you have.
• Postoperative management – details of the care you receive after the operation.
• Follow up and feedback – we see you about three months after the operation.
• Audit data – we collect outcomes when we see you and record it carefully.

What happens before the clinic

You will be sent a clinic appointment, with that you will also receive:

• An information leaflet and a consent form for photography - we take photographs of your hernia if you give us your consent. The photographs are very helpful in documenting the size of hernia and for making management plans.
• A nine page health questionnaire which you complete at home.  It asks for details on your previous surgery, if hernia surgery had been performed before, and any details of other medical problems you have.  This allows you ample time to recollect information that we would need. By filling this questionnaire at home we hope you do not feel rushed in a clinic. It allows us to get as accurate information as possible.

What happens in clinic

The York Abdominal Wall Unit has set up a combined clinic with a gastrointestinal surgeon and a plastic surgeon.

Visit our page 'what happens in clinic' for full details.

Contact details

This service is provided by York Abdominal Wall Unit which is based at York Hospital.

Meet the team

Visit our 'meet the team' page to see photos of our consultant gastrointestinal surgeons, consultant plastic surgeons and abdominal wall research fellow.

Contact secretaries to:

• Mr S Chintapatla: Andrea Cussans - 01904 721154
• Mr P R Chitsabesan: Kim Barnes - 01904 725761
• Mr T M MacLeod: Sarah Buttery - 01904 721605
• Mr P Lim: Sarah Buttery - 01904 721605

Patient information leaflets

We aim to support you by providing detailed information.  In the clinic you will receive personalised information, however once you leave the clinic you may want to reflect on what has been said.  We have written a number of patient information leaflets to help at various stages of your care.

• Abdominal Wall Reconstruction health questionnaire
• Abdominal Wall Hernia assessment form
• Complex Abdominal Wall Hernia includes Stoppa Mesh Repair and Component Separation Techniques
• Consent for Complex Abdominal Wall Hernia repair
• Information on clinical photography or video recording 
• Consent form for clinical photography or video
• Information leaflet on getting fitter for CAWR surgery
• Information leaflet on using pre operative 'botox’ injection to abdominal wall in Complex Abdominal Wall Hernia
• Consent form for pre operative botox in Complex Abdominal Wall Reconstruction
• Recovery after major abdominal surgery

Feedback

We would like to hear from you.  If you feel there are areas that we can develop further in terms of information provided or access to service please let us know by writing to Mr S Chintapatla, Consultant Surgeon:

Address: Department of General Surgery, 4th Floor, York Hospital, York, YO31 8HE

Or email to: andrea.cussans@nhs.net