Hi eab,
Sounds pretty normal. The best way to think of a hernia is to imagine your abdomen is just like a trampoline mat. If there's any flaw or weakness in the mat, a tear will develop. When you're given a stoma, the surgeon slices through your abdominal 'mat' and then stitches it closed when they're done. That creates a weak point all along the incision. The pressure inside your abdomen is constantly pushing on your 'mat', and any time you cough or lift something heavy, you'll notice your abs tighten up...which means pulling in...which creates even more pressure inside your abdominal cavity...and eventually, the weak spot gives out.
When they go to repair the tear, they can't pull the layers of your abdominal muscles and overlap them...because it's not a single layer, but multiple layers and not the same. So they have to butt the two sides of each layer together and stitch from one side to the other...like your shoelace pulls on the two sides of your sneaker when cinched up. And that type of repair is never as strong as one where you can overlap both sides and stitch through the whole deal. So while it's repaired, the weak area of scar tissue will never be as strong as the rest of your untorn abdominal 'mat', and the area will always be susceptible to more tears. So the surgeon places mesh (think window screen) in the layers of your abdominal tissue to make the incision area stronger. The mesh is sutured in place to keep it from moving around, and if it's an absorbable mesh, it will dissolve as your tissue grows through it and replaces it over time. If they use a permanent mesh that doesn't degrade, then the area is stronger faster, but the mesh will degrade over time, but not disappear...so not as strong as having all tissue there. Also, the porosity of the mesh is very important...as very small pores can make your immune system fire up, thinking it's the enemy, and you'll have an inflammatory response, which will hamper your muscle tissue from filling in the holes in the mesh, which isn't good. On the flip side, if the mesh is too coarse, your muscle fiber might not be able to adequately fill in the space.
So there's more to it than meets the eye, which is why finding a skilled surgeon who knows what they're doing is really important. There are lots of wrong answers and only a couple of right ones for each person. And of course, it's important to give your abdominal muscles time to fully engulf the mesh...or you can guess what happens. And every time they have to cut and go in...they're further weakening your abdominal ‘mat'.
Hernia repair is a specialty, yet it seems every surgeon thinks they can do it. Not saying yours can't, but I'd inquire about the number of times they've done it...and their success rate. You won't hurt their feelings, but rather show them that you're a concerned patient. And sometimes that goes a long way.
;O)
