Establishing a robust multidisciplinary team process in complex abdominal wall reconstruction within a colorectal surgical unit

There is an increasing disease burden of complex abdominal wall herniation [ 1 ]. This is likely secondary to improved survival following intra-abdominal catastrophe, an ageing population and failure of primary hernia repair (both open and minimal access techniques). Colorectal surgeons continue to contribute to the problem; incisional hernia rates following midline laparotomy remain high at 22.4% at 3 years [ 2 ], and controversy remains regarding the best method of primary closure to prevent future herniation [ 3 ]. Even when strong evidence exists to support one type of primary closure over another, uptake of new techniques remains poor. Due to the nature of the pathologies and the procedures that often create the initial problem, these patients frequently find themselves in the colorectal surgical clinic.