Advanced abdominal wall reconstruction is a team effort by plastic and reconstructive surgeons and experienced hernia surgeons. It is an extensive procedure, and typically used for very high risk hernias, complex hernias and hernias that have failed many other attempts at repair.

Normally, the weight of the abdominal contents are directed downwards into the pelvis. When there is a large hernia, the weight of the contents is often left lying against the repair, pushing forward, which stretches and loosens over time. A correctly performed abdominal reconstruction procedure directs the weight back into the pelvis, thereby taking the weight off of the repair. It redirects the intrabdominal contents anatomically, down into the pelvis. Pressure is taken off of the abdominal wall, minimizing the chance of recurrence.