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India Today spoke with Dr. Shivaprasad G.S., Senior Consultant, Manipal Hospital, on their treatment and challenges. WHAT DOES THIS HERNIA LOOK LIKE? "Most people know hernias as a small bulge in the belly, but giant recurrent hernias are much more serious," says Dr. Shivaprasad. "In extreme cases, the abdomen looks like a second belly because the intestines and stomach are no longer contained within the normal abdominal cavity." Symptoms patients may notice include:

• Persistent large swelling in the belly
• Pain or heaviness, especially while walking or bending
• Difficulty swallowing, constipation, or vomiting if the intestines get blocked
• Sores or ulcers on the stretched skin
• Breathing difficulties due to pressure on the lungs

WHY IS IT SO HARD TO FIX? Dr. Shivaprasad explains, "Repairing massive hernias is not just about pushing organs back. Previous surgeries create scar tissue, and the abdominal muscles may be weak or missing. Moving everything too quickly can put dangerous pressure on the heart and lungs." HOW DO DOCTORS REPAIR IT? "Such cases require careful planning and a multi-specialty approach," he says. "We start with imaging to understand how much space the organs need. If adhesions exist, we gently release them. Then, we repair the abdominal wall using strong medical meshes or, in some cases, tissue grafts like a Tensor Fascia Lata from the thigh to replace lost muscle." A REAL STORY OF HOPE Dr. Shivaprasad shares, "I recently treated an 80-year-old man who had lost a large part of his abdominal wall after intestinal cancer. His organs had slipped into the hernia sac. A combined team approach, using mesh repair and tissue grafting, successfully rebuilt his abdominal wall. Today, he is recovering well and enjoying life again." "Giant recurrent hernias are amongst the toughest surgical challenges," concludes Dr. Shivaprasad. "With timely intervention, advanced techniques, and teamwork, even complex cases can have positive outcomes."