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We get it—hernia surgery is no fun. But surgery is often the best way to fix the problem for good! Unfortunately, recovery may not seem quick, though. While everyone heals differently, certain activities are temporarily off the table.

Of course, you'll wonder when you can return to work, work out, and do other day-to-day stuff. But let's be honest - we know the intimate questions are on your mind, too. When can I have sex again? How do I ease back into it? Could getting intimate re-injure the delicate area?

It's awkward, but these worries are totally normal! Your love life is complicated enough without adding recovery rules to the mix. But have no fear - I'm here to tell you everything you need to know before getting intimate again after hernia surgery. 

So, without any further ado, let’s get into it!

Will Hernia Surgery Disrupt My Sex Life?

I know it is not the most comfortable topic! But clear information prevents worries and empowers you to bounce back better. This is even more important since Havard Medical School reported that 25% of men globally will experience inguinal hernia during their lifetime.

First, inguinal hernias in the groin/pelvic area are most likely to cause concerns for men. That region houses nerves and vessels essential for sexual function. When there's a hernia and surgical repair there, it's normal to stress about possible adverse effects downstairs.

While hernia surgery does involve some delicate work near critical structures, the good news is that there is minimal long-term sexual impact for most patients! Nerves are carefully preserved, and tissues are healed. Doctors utilize specialized techniques to safeguard sensation and function.

Still, utilizing surgical site muscles may initially be difficult or uncomfortable during intimacy. Soreness also temporarily challenges engaging relevant muscles. However, this impairment is short-lived. As post-operative swelling resolves and muscles heal, associated sexual difficulties dissipate, and normal function resumes.

The exact recovery duration varies from person to person. Deciding factors include hernia location, health status, surgery complexity, etc. But generally, take a minimum of 1 week off sex initially, as anesthesia causes fatigue anyway. Give your body proper rest! After that baseline time period, you can try resuming intimacy carefully. But stop immediately if you feel any pain or discomfort. That's a red flag, signaling that you still need more healing time.

Will I Get Erection After My Hernia Surgery?

It's understandable to be worried. Bruising, swelling, and discomfort around the genital region are common initially post-op. Fortunately, the risk of permanent injury to blood vessels, nerves, or reproductive structures remains extremely low.

Laparoscopic mesh repairs utilized for inguinal hernia surgeries are designed to safeguard and preserve function. So, your ability to get an erection should not be compromised long-term after proper healing occurs.

Remember that potential swelling and bruising are typically localized to inguinal hernia sites near the groin. Other hernia operations don't carry this same risk of temporarily impacting erections.

The key is being patient through the healing process. With time, swelling diminishes, and normal function steadily comes back online. 

Will Sex Be Painful After Hernia Repair?

Some tenderness is expected. But with the proper precautions, you can transition back to comfortable sex.

Incisions and mesh implants understandably cause some postsurgical soreness. Men may also experience genital swelling, decreasing desire initially.

Crucially, wait until your doctor gives the green light before attempting intercourse again. Also, choose sex positions that avoid abdominal pressure or irritation. Be ready to stop if you feel like you may pull on surgical sites or experience any amount of real pain. 

Regulating Sex Intensity After Hernia Surgery

Your surgeon will likely advise you to lay off anything too vigorous initially while you heal up. So, marathon sex sessions are off the table those first few weeks.

But when the green light does come for getting intimate again, be upfront with your partner. Share what activities you're comfortable trying or still nervous about. This lets him/her understand where you're at physically/mentally after the operation.

The key is not rushing back into your usual sexual routine until your body and mind feel prepared. There's no shame in needing to ease back into things or abstain from certain positions aggravating discomfort. So, communicate openly with your partner and avoid overdoing activities that could strain your surgery site.

Tips for An Injury-Free and Enjoyable Sex Post-Operation

Here are 5 tips for restoring comfortable, satisfying intimacy after hernia surgery:

Final Words

Bottom line - hernia surgery may bring a temporary setback in your sex plans. However, it’s best to hold off for now till you are fully recovered. 

Recovery time varies depending on the procedure, your unique body, age, and other factors. However, doctors typically recommend waiting at least a week post-op, sometimes longer.

Recovery from hernia surgery is a marathon, not a sprint! Avoid anything that aggravates pain or swelling, even once the initial recovery period passes. But stay confident that with patience, your sex life will be firing on all cylinders once again before you know it!

Hernias can definitely be a pain - quite literally! That uncomfortable bulging and occasional stabbing discomfort is your body's way of saying something's not right. 

While small hernias may seem harmless, they can lead to complications over time. Surgery is often needed to close up and reinforce weak spots where organs or tissue squeeze through abdominal muscles. 

It's normal to have some swelling or bloating around the site post-op while things heal. However, this sudden puffy tummy can make patients wonder – “Will my stomach shrink back to normal eventually after hernia repair?” “Or am I destined to look a few months pregnant forever?” “How can I find top hernia doctors near me that’ll come to my rescue?”

Don't worry – we’ll answer these questions and more in today’s post. We’ll also show you why bloating happens, as well as give tips to reduce it faster and fully return to your usual shape. 

Let’s get started!

What Causes Hernia in the Abdominal Region?

There are a few common culprits:

Essentially, a bulge can form over time if there's underlying strain, stretching, or inherent abdominal wall weakness.

How Serious is Abdominal Hernia Repair?

Now for the good news – abdominal/ventral hernia repair risks are low these days, especially if an experienced hernia surgeon uses a minimally invasive approach. Many smaller ventral hernias can even be fixed as an outpatient surgery.

Larger or more complex cases may require a 1–2-day hospital stay. But major complication rates should remain under 1% with the right hands at work. The procedures are common and generally very safe.

The Basis of Swelling After Hernia Surgery 

Swelling after surgery is your body's dramatic way of sounding the alarm bells that trauma occurred. All the poking, prodding, and rearranging during a hernia repair procedure inevitably scares your system a bit.

First, the hernia surgeon must cut through various skin and abdominal muscles layers to access the faulty area. Just entering the abdominal cavity exposes it to air, so extra air is often pumped in to give the surgeon room to work.

Although they remove as much excess air as possible before closing up, some inevitably get trapped inside post-surgery. It takes time to reabsorbed and release from the body, especially since staples, stitches, or surgical glue are used to seal the external incision site. 

Next, your immune system kicks into overdrive internally in response to the trauma. Blood circulation and fluid production surge to the region to transport infection-fighting cells and proteins needed for healing. When a bruise swells up and changes color, this influx of fluid and blood leads to unsightly puffiness and discoloration around hernia repair sites as the area heals.

When Will the Swelling End?

That timeline can vary from person to person. Most people deal with some degree of inflammation and fluid buildup for the first 1-2 weeks post-op. But for some, the swelling takes its time fading - sticking around for many weeks or even months in rare cases.

Several factors affect how quickly the puffiness starts to subside:

Will My Stomach Shrink After Hernia Repair?

Well, not directly - the stomach itself stays the same size. However, some secondary factors can lead to a flatter, firmer abdomen after the swelling subsides.

If a hernia is causing bloating or protruding outward, fixing it can take pressure off and tighten things up. Building stronger core muscles through activity post-surgery also helps create a more toned tummy over time.

Tips to Relieve Swelling After Hernia Repair

It's totally normal to experience some swelling and bloating post-surgery. But the good news is there are small things you can do to help minimize discomfort during the healing process! 

Choose Foods That Reduce Bloating 

I recommend sticking to fruits, veggies, and other nutrient-dense foods in the initial recovery period. Things like avocados, berries, cucumbers, ginger, and bananas are all great options that can help prevent gas buildup. On the flip side, try to avoid greasy meals, dairy, or sodas for now - these tend to irritate the digestive system. The better you fuel your body, the less inflammation you'll deal with!

Stay Regular Bowel Movement-wise

Keeping your bowel movements frequent and soft is crucial for feeling comfier as you recover. Constipation, unfortunately, allows gas and bloating to build up. The anesthesia, surgery, and medication can make digestive slowdown a real issue. Consider a gentle stool softener to ease bowel movements and reduce abdominal expansion from the trapped gas. The more regular you are, the less cramped and distended things will feel!

Walk It Out 

Believe it or not, staying lightly active can tremendously help minimize swelling and support healing! Nothing intense - listen to your body to avoid overexertion. Some gentle walking or range of motion exercises get things moving internally too. Just be mindful not to overstretch tissues at the tender surgery site. 

Get Plenty of Rest 

Healing takes lots of rest! Make sure to create time for relaxation as your body repairs itself - minimize disruptions or excursions at first. Consider this as permission to nap and take it easy without distractions.

Follow Post-Op Instructions 

Before discharge, your hernia doctor will share guidelines for recovering comfortably at home. Be sure to stick to these! Strictly following their custom recovery plan minimizes risks and complications down the line. Don't hesitate to ask clarifying questions either - the more you understand the instructions, the smoother your healing.

Don't Skip Follow-Ups 

It's tempting to cancel if you feel okay, but those post-op check-ins are mandatory! Monitoring your progress regularly enables the hernia surgeon to confirm you're healing as expected and catch any hiccups early. 

Key Takeaways

Temporary swelling is totally normal post-op as your body kicks into healing mode. So, no need to panic! 

Patience is key over the next few weeks while the inflammation resolves itself and things settle into place. Also, maintaining good nutrition and an active lifestyle after surgery is what really transforms your body for the better.

Lastly, maintaining open communication with your surgical team allows you to voice any questions or concerns along the way. So, do a quick online search of “Top hernia surgeons near me” to ensure quality healthcare. Their guidance, combined with patience and self-care, will have you looking and feeling like your best self again soon!

Hernia repair surgery is a common medical procedure.  Over 1 million inguinal hernia repairs and 600,000 ventral/incisional abdominal hernia repairs are done every year.  Hernia mesh has become a prevalent method for reinforcing weakened abdominal walls. Hernia mesh, also known as surgical mesh, is a material that helps support the weak tissue around the hernia and aids in the healing process. While hernia mesh has proven to be effective in many cases, concerns about its safety have also arisen. In this blog, I will delve into the benefits of hernia mesh, its potential complications, and ways to ensure a safe and successful hernia repair.

Benefits of Hernia Mesh

  1. Reduced Risk of Recurrence: Hernias tend to recur if not repaired with mesh reinforcement. In most hernia repairs, mesh provides critical additional support to the weakened area, significantly reducing the risk of recurrence.
  2. Minimized Recovery Time: Hernia mesh allows for tension-free repair in inguinal hernia repairs, which often leads to a quicker recovery period compared to traditional suture-based repairs.
  3. Strengthens Tissue Healing: The mesh acts as a scaffold for the body's natural tissues to grow, aiding the healing process and creating a strong repair over time.
  4. Necessary for Complex Cases: Hernia mesh is particularly necessary for medium to large ventral/incisional hernias and cases involving weakened or scarred tissue where traditional repairs have failed.  The recurrence rate is so high without mesh that hernia surgery should not be performed if mesh cannot be used.

Potential Concerns and Complications

  1. Infection: One of the primary concerns is the risk of infection. While modern mesh materials are designed to resist infections, there is still a small chance of the mesh becoming a breeding ground for bacteria.
  2. Adhesions: Adhesions occur when scar tissue forms and binds nearby organs or tissues to the mesh, potentially causing discomfort or bowel obstruction.
  3. Migration or Shrinkage: There have been cases of the mesh migrating or shrinking over time, which could lead to discomfort, pain, or recurrence of the hernia.
  4. Allergic Reactions: Extremely rare, some individuals may experience an allergic reaction to the materials used in the mesh.  I have not seen this in my nearly 20 years of practice.
  5. Chronic Pain: Chronic pain around the surgical site is a possible complication with any surgery (ie cardiac, plastic, orthopedic, etc.).  It is often attributed to irreversible tissue damage, nerve damage or the body's reaction to implants.

Ensuring Safety and Success

  1. Choose an Experienced Surgeon: Select a surgeon who specializes in hernia repair and has a track record of successful outcomes using mesh.
  2. Discuss Mesh Options: There are different types of hernia mesh available, including absorbable and non-absorbable varieties. Discuss with your surgeon which option is best for your situation.
  3. Understand the Risks: Before undergoing surgery, thoroughly discuss potential complications with your surgeon and have a clear understanding of the risks involved.
  4. Monitor and Report: After surgery, pay attention to any unusual symptoms or discomfort and promptly report them to your healthcare provider.
  5. Lifestyle Factors: Follow your surgeon's pre-operative instructions.  Many modifiable risk factors are associated with increased surgical risks, such as obesity, smoking, poorly controlled diabetes, malnutrition and immunosuppression.  Be as healthy as possible going into surgery to minimize complications.  After surgery, maintain a healthy lifestyle, and avoid activities that strain the surgical site during the recovery period.

Conclusion

Hernia mesh has provided significant benefits to countless patients by improving the success rate of hernia repair surgeries. While concerns about safety do exist, choosing the right surgeon, understanding the potential complications, and adhering to the surgeon’s instructions can greatly minimize these risks. As with any medical decision, it's important to have an open and informed discussion with your surgeon to determine the best approach for your individual situation.  

Call Dr. Rockson Liu at 510-465-5523 or fill out the consultation request form for an individualized consultation.  He will personally review your medical records and imaging, interview you, and examine you to find the best surgical (or non-surgical) option that is tailored for your specific situation.

Recovering from hiatal hernia surgery requires careful consideration of dietary choices. Healthcare professionals sometimes advise against consuming chocolate post-surgery. In this blog, we explore the reasons behind this recommendation and the consequences of disregarding it. We also provide alternatives and wellness strategies for a smooth recovery. 

The Complex Nature of Hiatal Hernia Surgery

Before we delve into the specifics of avoiding chocolate post-surgery, it's crucial to understand the intricacies of hiatal hernia surgery. Hiatal hernias occur when a portion of the stomach protrudes into the chest cavity through the diaphragm's opening (hiatus). The surgery involves repositioning the stomach by moving the stomach out of the chest cavity and into the abdominal cavity.  The enlarged hole in the diaphragm (hiatus) is reduced in size but sewing diaphragm muscle together.  Sometimes a piece of mesh may be used to reinforce the hiatus repair.  Finally, an antireflux procedure such as a fundoplication (aka wrap) or magnetic sphincter augmentation (aka LINX) is performed.  Usually, the primary goal of the surgery is to alleviate reflux symptoms such as heartburn, regurgitation and chest pain.  

Dietary Considerations After Hiatal Hernia Surgery

The period following hiatal hernia surgery is pivotal for recovery.  There are two important dietary considerations during the recovery period.  

Firstly, the integrity of the hiatal hernia repair relies solely on the sutures holding the tissue together for the first few weeks.  Scar tissue and the healing process do not reinforce the repair until several weeks after surgery.  The suture repair can easily fall apart with forceful contraction of the diaphragm, leading to recurrence of the hiatal hernia or herniation of the wrap into the chest.  Retching and vomiting are the main causes of forceful contraction of the diaphragm. Consequently, dietary choices are extremely important during the recovery period to avoid retching and vomiting. This gets to the most important dietary consideration after hiatal surgery:  avoid foods that can get stuck in the esophagus.  When food gets stuck, not only will it cause severe chest pain, but it will also cause retching and vomiting.  

Typically, the fundoplication is swollen immediately after hernia surgery.  This swelling can prevent food or large pills from passing through easily.  I start patients on a liquid diet for the first week or two after surgery.  Anything that can be poured is considered a liquid.  In the second or third week, if the liquids go down smoothly, I then recommend advancing to soft foods.  I ask patients to avoid bread, rice, and chunks of meat for at least 2 weeks and until soft foods go down ok; these foods tend to get easily stuck in the wrap.  Also, just as important, is to chew well and eat slowly for a few months.

The second dietary consideration aims to prevent symptoms that could complicate recovery and increase discomfort after surgery.  After hiatal hernia surgery, chest pain and esophageal sensitivity are common from the extensive dissection around the esophagus and chest during surgery.  Therefore, foods that typically exacerbate heartburn and reflux should be avoided.  It's in this context that healthcare professionals often recommend avoiding chocolate.

Why No Chocolate After Hiatal Hernia Surgery?

While the recommendation to abstain from chocolate post-surgery might not be backed by extensive scientific studies, it's rooted in a sound understanding of the effects of chocolate on the lower esophageal sphincter and reflux symptoms.  Studies in healthy volunteers in the 1960’s and 70’s showed that eating chocolate relaxes the lower esophageal sphincter, which is the barrier that prevents gastric contents from refluxing into the esophagus.   Eating chocolate, can therefore, increase heartburn and reflux symptoms, as the barrier between the stomach and esophagus is relaxed by chocolate.  This is why chocolate is alway on the list of food to avoid in patients who have GERD or heartburn.  Chocolate also contains lipids or fats and caffeine, which can stimulate the production of stomach acid.  

The Consequences of Consuming Chocolate After Hiatal Hernia Surgery

The decision to ignore the advice to avoid chocolate post-surgery can result in a range of consequences, albeit minor, including:

Acid Reflux: Acid reflux is a common concern for individuals with hiatal hernias, and the consumption of specific foods and beverages, including chocolate, can trigger this condition.  Although the hiatal hernia repair is meant to bolster the lower esophageal sphincter and prevent acid reflux, and alleviate acid reflux symptoms, it can be difficult in the immediate post-operative period to tease out whether symptoms of chest pressure and heartburn are due to actual reflux or just typical post-surgical inflammation and esophageal sensitivity.  Avoiding such triggers, such as chocolate, is recommended to minimize these symptoms and the distress caused by these symptoms.

Stomach Pain: Some individuals have heightened sensitivity to fats and caffeine. Consuming chocolate after hiatal hernia surgery can disrupt the digestive system due to the presence of fats and caffeine, potentially leading to stomach discomfort and pain.

Rocky Recovery:  Patients, as mentioned earlier, typically experience chest and abdominal pain, as well as heartburn-like symptoms in the postoperative period - even when surgery goes smoothly.  Combined with the other typical post-operative symptoms of nausea, incision pain, and general tiredness, it is reasonable to minimize activities, foods, and other environmental factors that can exacerbate these symptoms.  Therefore, avoiding chocolate and other foods that can disrupt the digestive system, is recommended.

Bottom line is chocolate will not harm the hiatal hernia repair or cause any long-term consequences if eaten after surgery.  It simply may increase postoperative discomfort during recovery and increase anxiety about the effectiveness of the hiatal hernia surgery.  Eating chocolate is certainly not as bad as retching or vomiting, which should be avoided at all cost if possible. 

Dietary Alternatives and Wellness Strategies

While the temporary exclusion of chocolate from your post-surgery diet is advised, we can explore alternative dietary choices and wellness strategies that promote healing without compromising your comfort. Here are some options to consider:

Fruit: Fresh fruits such as apples, pears, and bananas can provide a naturally sweet and satisfying alternative to chocolate. Not only are they nutritious, but they are also gentle on the stomach.  But remember, raw fruits should be avoided in the first 1-2 weeks until the swelling from the hiatal hernia repair has resolved.

Yogurt: Opt low fat yogurt, which can be a soothing option for those seeking a creamy treat.

Herbal Teas: Herbal teas, including chamomile or ginger tea, can offer a soothing and caffeine-free alternative. They are known for their calming properties and can be a delightful beverage during the recovery period.

Water: Staying hydrated is essential for the healing process. Water aids in digestion and overall well-being.

Consult Your Healthcare Provider

It's essential to remember that the decision to include or exclude specific foods from your post-hiatal hernia surgery diet should be made in consultation with your healthcare provider or surgeon. They can offer personalized dietary recommendations based on the specifics of your surgery, your individual recovery progress, and your overall health status.

Incorporating a Holistic Approach to Healing

In addition to dietary considerations, it's vital to adopt a holistic approach to healing after hiatal hernia surgery. This approach includes lifestyle modifications such as:

Stress Management: Reducing stress can have a positive impact on your digestive health. Techniques like deep breathing, meditation, and yoga can be beneficial.

Elevating the Head of Your Bed: This simple adjustment can help prevent stomach acid from flowing back into the esophagus, reducing the risk of acid reflux during sleep.

Small, Frequent Meals: Consuming smaller, more frequent meals can be easier on your digestive system, reducing the risk of post-surgery discomfort.

Balancing Nutritional Needs

While avoiding chocolate is recommended, it's essential to maintain a well-balanced diet that meets your nutritional needs during the recovery phase. Working with a registered dietitian or nutritionist can help you create a meal plan that supports your recovery and overall health.

In Conclusion

The decision to avoid chocolate after hiatal hernia surgery is rooted in the potential impact of its ingredients on post-operative comfort. While scientific studies might not conclusively support this recommendation, it aligns with a broader approach to dietary care for individuals with hiatal hernias. By prioritizing your well-being, making thoughtful dietary choices, and consulting your healthcare provider, you can contribute to a smooth and successful recovery.

Your journey towards recovery is a vital phase in regaining your health and comfort. By considering these recommendations and seeking professional guidance, you can navigate this phase with confidence and set the stage for a healthier future.

If you're faced with the discomfort of a hernia, you're not alone. Hernias can be painful and disrupt your daily life, but the good news is that hernia surgery can offer relief. One of the most common questions patients have is, "How long does hernia surgery take?" The answer isn't straightforward, as several factors come into play. In this comprehensive guide, we'll delve into the duration of different hernia surgeries, including laparoscopic or robotic basic hernia surgery, robotic complex hernia surgery, and open complex hernia surgery. 

Hernia surgery isn't just about alleviating physical discomfort; it's a step toward reclaiming your quality of life and regaining the ability to engage in activities you enjoy. By understanding the intricacies of the surgery and the factors influencing its duration, you're taking a proactive step towards informed decision-making and a smoother recovery journey.

Understanding Hernia Surgery

First, let's grasp the basics of hernia surgery. A hernia occurs when an organ or tissue pushes through a weak point in the surrounding muscle or connective tissue. Surgery is the primary treatment, involving the repositioning of the protruding organ or tissue and the repair of the weakened area. Surgical techniques vary, including open surgery and minimally invasive options like laparoscopic and robotic surgery. The choice depends on factors such as the hernia type, complexity, patient factors, patient preferences, and the surgeon's expertise.

Factors Affecting Surgery Duration

The duration of hernia surgery hinges on several factors, including:

Typical Duration of Hernia Surgeries

Now, let's delve into the typical durations of various hernia surgeries:

  1. Open Simple Ventral Hernia Surgery:  Ventral hernias is a broad term that usually refers to denovo (i.e. not caused by previous surgery) hernias of the abdominal wall.  These hernias are considered “primary” hernias and typically occur in the umbilicus (belly button) or the epigastrium (the area between your belly button and sternum).  Ventral hernias tend to be small, ie width are around 2cm or less.  On average, basic open ventral hernia surgery lasts between 30 minutes to an hour.
  1. Laparoscopic or Robotic Ventral Hernia Surgery:  These minimally invasive approaches tend to take longer than open surgery for small ventral hernias, but they tend to be more secure repairs that are less likely to fail.  On average, basic hernia surgeries of this type typically last between an hour to 2 hours.
  1. Laparoscopic or Robotic Inguinal Hernia Surgery: This minimally invasive approach boasts a quicker recovery time. On average, basic hernia surgeries of this type typically last between 30 minutes to an hour
  1. Robotic Complex Inguinal Hernia Surgery: Inguinal hernias are considered complex when the patient has old mesh in the groin, has had radiation to the pelvis, has had surgery in the pelvis (such as prostatectomy), or has a large hernia that goes into the scrotum.  Patient factors such as morbid obesity can also make inguinal hernia repairs more complex.  These surgeries require much more surgery time.  Complex hernias are difficult to complete laparoscopically, so most are done robotically.  Surgery times range from 1.5 to 3 hours or longer.
  1. Robotic Basic Ventral/Incisional Hernia Surgery:  Ventral/Incisional hernias that are larger, ie 2-4cm or patients who are at higher risk for failures from open repairs, benefit from robotic repair.  Robotic repairs allow mesh to be inserted behind the repaired defect to reinforce the repair, kind of like adding rebar to the abdominal tissue.  Basic Ventral/Incisional hernias typically take 1 to 2 hours to repair robotically.
  1. Robotic Complex Incisional Hernia Surgery:  Incisional hernias can be considered complex for many reasons, including multiple previous abdominal surgeries which increases the risk of adhesions, previous abdominal mesh, incarcerated hernias, or a hernia width greater than 5cm.  There are many more factors and the list is much too long and complex for this write-up.  Arrange for a consultation with Dr. Rockson Liu to determine if your hernia is considered complex.  The length of these surgeries are highly dependent on patient factors and the skillset and experience of the surgeon.  What may be considered complex by an average surgeon may be considered simple by an experienced surgeon with advanced robotic skillset and advanced repair techniques. 
  1. Open Complex Hernia Surgery: In Dr. Rockson Liu’s practice open surgery is reserved for only the most complex incisional hernias, since hernias fixed with open surgeries have higher complication rates and longer recovery.  Hernias that usually require open surgery include ones with intestinal fistulas (and opening of the intestine through the skin of the abdomen), giant defects (greater than 15cm wide), and loss of domain (most of the intestine resides outside of the abdominal cavity).  For open complex hernias surgery the operative time is highly variable but usually take 5 to 8 hours or even longer, contingent upon the hernia's size and complexity.

Remember that these are general timeframes, and individual cases can vary significantly. Your surgeon will provide a more precise estimate tailored to your specific condition.

Minimally Invasive vs. Open Surgery

While considering hernia surgery, you may wonder whether to opt for minimally invasive surgery or the traditional open approach. Beyond surgery duration, other factors, such as recovery time and potential complications, also factor into your decision.

Recovery and Postoperative Care

After hernia surgery, your recovery time isn't solely dependent on the duration of the surgery itself. Variables like your overall health, the type of anesthesia administered, and your body's response to surgery also come into play. Generally, patients can expect to resume regular activities within a few weeks, with complete recovery taking a bit longer.

Postoperative care is vital for a successful recovery. Your surgeon will provide specific instructions to follow during the recovery period. This may include restrictions on lifting heavy objects, dietary guidelines, and prescribed medications for pain management. It's crucial to adhere to these recommendations to ensure a smooth recovery process.

Consultation with a Surgeon

For precise information about the expected duration of your hernia surgery, it's crucial to consult a hernia specialist or surgeon. They'll assess your specific condition, considering factors like your overall health, the size and complexity of your hernia, and the surgical technique to be used. Based on this assessment, they'll provide a personalized estimate of the surgery's duration.

During the consultation, don't hesitate to ask any questions or express concerns you may have. Your surgeon is there to provide you with all the information you need to make an informed decision about your surgery.

Conclusion

In conclusion, the duration of hernia surgery isn't one-size-fits-all; it hinges on numerous factors. Whether you're considering laparoscopic, robotic, or open surgery, consult a qualified surgeon who can offer a precise estimate and guide you through the process. An informed decision can lead to a smoother surgical experience and a speedier recovery.

With this comprehensive guide, you're better equipped to understand and prepare for your hernia surgery, ensuring you're on the path to a healthier and more comfortable life.

We want you to return to health as soon as possible.

We understand that being diagnosed with a hernia can be scary and stressful. You probably have a lot of questions and some anxiety. This guide is designed to help you understand hernias, common terms used with hernias, how hernias are diagnosed, what hernia surgery is appropriate and what to expect with surgery. Your surgeon will go into more detail regarding your specific situation. Our goal at The PATCH Institute is to arm you with information, provide you with the best experience, and give you the best results.

What is a Hernia?

A hernia occurs when the inside layers of the abdominal wall have weakened, resulting in a bulge or tear. In the same way that an inner tube pushes through a damaged tire, the inner lining of the abdomen pushes through the weakened area of the abdominal wall to form a small balloon-like sac.

The weakness may be present at birth, can be caused by wear and tear of daily living, or by surgeries.

Men, women and children of all ages can get a hernia.

A hernia does not get better over time, nor will it go away by itself.

What causes a hernia?

The wall of the abdomen has natural areas of potential weakness. Hernias can develop at these areas.

Anyone can develop a hernia at any age.

Surgeries that require cutting through the abdominal wall can also create weaknesses and hernias.

How do I know if I have a hernia?

The common areas where hernias occur are in the groin (inguinal), belly button (umbilical), and the site of a previous operation (incisional).

You may notice a bulge under the skin.

You may feel pain when you cough, lift heavy objects, strain during bowel movements or urination, or during prolonged standing or sitting.

Some hernias do not cause pain or a bulge, and may be discovered during CT or MRI, or during routine physical exam.

Do I need to have my hernias fixed?

You should always have a hernia evaluated by a doctor. The doctor will help you determine if surgery is necessary and if surgery is safe in your situation.

You should have surgery if the hernia is enlarging rapidly, causing pain or limiting the activities you do normally.

You should have it fixed, if you’ve had an intestinal blockage due to a hernia.

Hernias that aren’t causing pain, intestinal blockage and aren’t enlarging can sometimes be observed. Consult your doctor.

How are hernias fixed?

A hernia repair usually involves two steps:

  1. Closing the hole or weakened area
  2. Applying mesh to reinforce the repair

Repairs can be accomplished with open, laparoscopic, robotic or a combination of techniques. Each technique has its pros and cons. Usually repairs using small incisions, such as laparoscopic or robotic, lead to faster recovery and less complications.

Larger or recurrent hernias can be very complex and require a hernia specialist to obtain the best results. The hernia specialist will have more knowledge, tools, techniques and skills to tailor the best operation to your situation.

RECOVERY AFTER HERNIA REPAIR

Most patients undergoing hernia repair for the first time can safely and comfortably go home the same day. Patients who need an abdominal wall reconstruction for large hernias or have advanced medical conditions will remain in the hospital.

The rate of recovery is dependent on many factors.  The type of surgery, pre-existing pain, cultural expectations, personal pain threshold and complexity of surgery all play a role in the pace of recovery. At The PATCH Institute, we focus on these factors as it applies to you, and develop a multi-pronged Enhanced Recovery and Comfort (ERC) Program to help you recover as quickly as possible. Our ERC Program focuses on the 3 stages of surgery: pre-operative, operative and post-operative.

Pre-Operative Pain Management

Studies have shown that medications and nerve/field blocks can blunt the pain signals transmitted to the brain. This is called pre-emptive analgesia. By blunting the pain signal transmission, patients usually experience less pain during and after surgery. With our ERC Program, we can utilize several medications including (oral or IV) acetaminophen, Cox-2 inhibitors (e.g. Celebrex), gabapentinoid (e.g. Lyrica) and/or opioid-receptor agonists (e.g. Tramadol). 

Operative Pain Management

One of the best ways to improve the speed of recovery is to perform surgery through small incisions using laparoscopy or advanced robotic surgical systems. As part of our ERC Program, we usually perform nerve or field blocks prior to incision or early in the surgery to blunt the pain signals.  Our anesthesiologists are trained in performing advanced nerve and field blocks such as TAP (transversus abdominis plane), Quadratus Lumborum, or Rectus Sheath blocks.

Post-Operative Pain Management

Most patients are concerned about experiencing too much pain after surgery. We will ensure that you are comfortable after surgery, but it is important to remember that pain is a way for the body to guide you. Pain will tell you when you need to rest or take it easy. Pain will tell you when you’ve overexerted yourself after surgery. Pain will tell you when you are potentially harming the repair. We do not want to completely eliminate pain. Also, to completely eliminate pain after surgery would require narcotics that can lead to severe constipation, dizziness and nausea. Constipation after hernia surgery is usually worse than the incisional pain itself.

The most important thing to do after surgery is to rest. After most hernia surgeries you will need 2-3 full days of rest. When you get home after surgery, plan to sleep a lot or rest on the couch. Over the next 2 days read a good book or watch some good movies/shows. You will be able to walk around the house or in the yard but focus on relaxing and resting. Many patients find herbal teas to be very soothing and relaxing also. Icing the incisions during the first 2 days is also recommended.

For the first 2 days, we recommend alternating Ibuprofen and Tylenol. When you get home start by taking Ibuprofen. Then 3 hours later take Tylenol. Continue taking each medication every 6 hours. This way every 3 hours you’re are taking a pain reliever. With this regimen narcotic pain pills are not necessary.

BELOW IS THE EXPECTED RECOVERY FOR EACH TYPE OF SURGERY


LAPAROSCOPIC OR ROBOTIC INGUINAL, UMBILICAL, & SMALL VENTRAL

COMFORT

Almost all patients are discharged home the same day. Ibuprofen and Tylenol work well together. Placing an ice pack over the incision during the first 48 – 72 hours also help. Remember, the goal is not to have zero pain, but to be comfortable at rest and with movement. Focusing on resting is very important.

Constipation is very common after surgery. You should have a bowel movement by the 3rd day after surgery. Take stool softeners and drink lots of fluids after surgery. If necessary, take an over the counter laxative such as milk of magnesia or use a fleet enema.

SHOWERING

If your incisions are dry, you may shower 48 hours after surgery. If your incisions are seeping or if you have a drain, ask your surgeon.

ACTIVITIES & RESTRICTIONS

You will be able to walk and use the stairs right away. Do not perform chores or drive for at least 1 week. Most patients can return to normal activities, including non-strenuous work, about 1 week after surgery.  If you perform strenuous work or activities, your surgeon may restrict those activities for up to 6 weeks.

OPEN INGUINAL, UMBILICAL, & SMALL VENTRAL HERNIA REPAIRS

COMFORT

Almost all patients are discharged home the same day. Ibuprofen and Tylenol work well together. Placing an ice pack over the incision during the first 48 – 72 hours also help. Remember, the goal is not to have zero pain, but to be comfortable at rest and with movement. Narcotics may be needed for the first few days. Focusing on resting is very important.

Constipation is very common after surgery. You should have a bowel movement by the 3rd day after surgery. Take stool softeners and drink lots of fluids after surgery. If necessary, take an over the counter laxative such as milk of magnesia or use a fleet enema.

SHOWERING

If your incisions are dry, you may shower 48 hours after surgery. Dressings should be removed before showering.  If your incisions are seeping or if you have a drain, ask your surgeon.

ACTIVITIES

You will be able to walk and use the stairs right away. Do not perform chores or drive for at least 1 week. Most patients can return to normal activities, including non-strenuous work, about 2-3 weeks after surgery.  If you perform strenuous work or activities, your surgeon will likely restrict those activities for 4-6 weeks.

LAPAROSCOPIC, ROBOTIC OR OPEN INCISIONAL HERNIA REPAIR

It is more difficult to describe an expected recovery pathway for this group of surgeries since incisional hernias can range in size from as small as a pea to larger than a watermelon.  Your surgeon will give you more details before and after surgery.


DIAPHRAGMATIC (HIATAL, PARAESOPHAGEAL) HERNIA REPAIR

Nausea and difficulty swallowing can occur after these repairs. Therefore, most patients are observed in the hospital overnight. An UGI – an x-ray where you swallow contrast dye – may be performed the following morning before you are discharged to examine the condition of the esophagus, tightness of the wrap and to rule out any leaks.

COMFORT

You will be given liquid pain medication or medications that come in very small pills. Because there will be swelling in your esophagus and the wrap, larger pills may have trouble passing the first week or two after surgery.

Retching and vomiting can cause serious problems after surgery. It may cause the wrap to slip or the repair to fall apart. You will be prescribed anti-nausea medications after surgery.

Liquid Ibuprofen and Tylenol work well together.  Icing the incisions during the first 48 – 72 hours will help.  Remember, the goal is not to have zero pain, but to be comfortable at rest and with movement. Focusing on resting is very important.

Shoulder pain is very common after diaphragm surgery. Frequent gentle shoulder/back massages and/or warm compresses help. Narcotic pain medications do not help for the shoulder pain.

SHOWERING

If your incisions are dry, you may shower 48 hours after surgery. If your incisions are seeping or if you have a drain, ask your surgeon.

ACTIVITIES & RESTRICTIONS

Continue walking often. Do not perform chores or drive for at least 1 week. Most patients can return to normal activities, including non-strenuous work, about 3-4 week after surgery.  The diaphragm is a very strong sheet of muscle and is used in strenuous work, vigorous exercise, coughing and sneezing. Since the repair involves suturing the diaphragm, any strenuous activity can damage the repair. Your surgeon will likely recommend avoiding heavy labor and sporting activities for several months.

DIET

As mentioned above, post-operative swelling can make swallowing large items difficult and potentially dangerous. Most patients will be required to start on a liquid diet for a week or two. If there are no swallowing problems, the diet is then gradually progressed from soft to regular food. Large chunks of meat, bread and rice can easily get stuck in the esophagus. 

The success of hernia surgery is frequently determined by how you prepare for surgery and what condition your body is in before surgery.  Many complications after surgery can be prevented by modifying risks factors before surgery.

Rehabilitation before surgery

The medical term "prehabilitation" comes from combining "pre" and "rehabilitation."  "Rehabilitation" is what we do after surgery to speed up recovery.  "Prehabilitation" is what we do before surgery to speed up recovery.

Great News!

Preparation before surgery can ensure success like giving an important presentation or running a race. Many complications after surgery can be prevented by you.  Taking an active role in your own care is very important for a fast and smooth recovery.

My Commitment

We don't just offer hernia surgery.  We are serious about prehabilitation.  We will work closely with your family doctor and the preop anesthesia clinic to improve your medical condition and overall health before surgery.

Smoking

Cigarette smoking and nicotine use in any form will reduce your ability to heal, and increases your risk of complications such as infections, wound separation, heart attacks, pneumonia and stroke. You should stop smoking at least 4 weeks before surgery.

Weight

Obesity increases complications. We measure obesity by the BMI (body mass index). A BMI of 30kg/m2 or less is ideal for hernia surgery. A BMI over 35kg/m2 is associated with more complications. If obesity makes surgery too risky to proceed, we will ask you to work with your medical doctor or dietitian to lose weight.  In some circumstances, we can offer weight loss surgery before hernia surgery.

DIABETES

Poorly controlled diabetes is a major reason patients have complications with surgery. If your HgA1C is above 7.5%, surgery should be postponed.

NUTRITION

Eating a healthy balanced diet is good for your overall health, but it also helps your body heal faster after surgery.  Increase fresh fruits and vegetables, and reduce processed foods and sugary drinks.

OVERALL HEALTH

Major hernia repair surgery is like running a marathon. The success of surgery frequently depends on your physical and mental condition going into surgery. Regular exercise and learning stress-reduction techniques before surgery will reduce your risks of complications.

Inguinal

Another name for groin hernias.  It's the 2nd most common type of hernia.  It is 10x more common in men.  These hernias can be divided into direct or indirect.

Umbilical

The most common type of hernia.  Everyone has a small opening in the belly button left by the umbilical cord.  This opening can enlarge, resulting in a hernia.  The hernia must be repaired when it is enlarging or causing symptoms like pain or intestinal blockage.

Incisional

This type of hernia develops where a surgeon has previously cut through the abdominal wall.  These hernias come in all sizes and complexity.  Many can be difficult to repair, and require a robotic hernia specialist to achieve a durable repair.  The PATCH Institute is one of the only centers in the Bay Area with extensive experience in robotic repairs.

Hiatal

This type of hernia occurs when the stomach slips through the diaphragm hiatus into the chest.  Frequently patients have heartburn, chest pain or trouble swallowing.  There are 4 types of hiatal hernias.  Repairs are usually done through the abdomen and involve pulling the stomach into the abdomen, tightening the diaphragm hiatus and performing a fundoplication (wrap).

Additional Hernia Types

Paraesophageal

This is a type of hiatal hernia but is frequently used by general surgeons to refer to very large hiatal hernia where more than 1/3 of the stomach is in the chest.

Epigastric

A hernia that occurs in the linea alba in the upper midline of the abdomen.  These usually are small and feel like small lumps under the skin.

Diaphragmatic

The diaphragm is a muscle and can develop hernias. Hiatal & paraesophageal hernias are the most common.  Less common types include Morgagni or Bochdalek.

Spigelian

Occurs in either lower quadrant of the abdomen, above the groin, where the posterior connective tissue layer thins.

Parastomal

A hernia that forms around a stoma (colostomy, ileostomy or urostomy).  More than 50% of patients with stomas will eventually develop a parastomal hernia.  These should be fixed when the hernia affects the function of the stoma, or causes pain or blockage. 

Ventral

This is a term that applies to all hernias in the front of the abdomen.  Usually they refer to larger umbilical hernias.

The PATCH Institute offers all options

The general scientific knowledge of hernias has grown exponentially in the last few years. Advancements in technology have also greatly increased our surgery options. The surgeons at The PATCH Institute are experts in utilizing the latest knowledge, techniques and technology to repair your hernia with the smallest scars, quickest recovery and lowest complication rate. During the consultation, your general surgeon will determine the best surgery option for you.

OPEN SURGERY

This is the traditional approach with a larger incision at the hernia bulge. This type of surgery is still preferred when the hernia is either very small or very complex. For example, many inguinal and umbilical hernias are many times best performed open. Open surgery is sometimes better in complex hernia repair when there is mesh to be removed, when intestine needs to be resected or when there is a lot of skin/fat that needs to be removed.

LAPAROSCOPIC SURGERY

A form of minimally invasive surgery introduced in the 1980’s. Laparoscopic surgery uses small incisions away from the hernia bulge.  It frequently leads to less complications than open surgery. Today, it is used for hernia repairs that don’t require advanced robotic surgical systems.  It has several limitations:  the surgeon uses straight instruments that may limit the precision of surgery, it is difficult to place mesh outside the abdominal cavity, more surgeon fatigue due to poor ergonomics, and it requires sometimes painful fixation tacks and sutures.

ROBOTIC-ASSISTED SURGERY

A form of minimally invasive surgery through small incisions. It utilizes advanced robotic surgical systems such as the daVinci robot. The robot is not autonomous. It is simply a more advanced surgical tool and is FULLY controlled by the surgeon. The robotic platform offers the surgeon fully wristed instruments and a 3D high-definition camera with 10x magnification. As a result, the repair can be done with more precision, and complex hernias can be fixed with small incisions. Furthermore, the robot doesn’t get tired and the surgeon sits during surgery, so there is less surgeon fatigue. For the patient, this translates into quicker recovery, less pain and less complications. This is the preferred approach for medium to large hernias and many inguinal hernias as it combines the best of open and laparoscopic surgeries. Also, the surgeon is more likely to be able to sandwich the mesh between layers of the abdominal wall to keep the mesh from coming into contact with the intestines.

HYBRID SURGERY

Sometimes the best option is to combine multiple techniques. We call this a hybrid technique because we may perform part of the operation robotically and another part open.  Hybrid surgery is frequently performed for complex or unusual hernias, and ones that require skin or soft tissue removal.  

Experience Matters

Regardless of the option that is right for you, the surgeon's experience is probably what matters most.  Using the latest robotic technology does not guarantee great results.  Frequently surgeons will promise a laparoscopic or robotic approach but have a high conversion rate to open surgery.  At The PATCH Institute we are experts at minimally invasive hernia repair, and have an extremely low conversion rate.

The leading minimally-invasive general and hernia repair surgeon on the West Coast, serving patients in the greater SF Bay Area. 

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