Hernia Surgery: Types, Recovery, and Prevention – A Surgeon’s Guide


Hernia Surgery: Types, Recovery, and Prevention – A Surgeon’s Guide
Photo by cottonbro studio:

A hernia occurs when an organ or fatty tissue pushes through a weak spot in the surrounding muscle or connective tissue. 

Common types include inguinal (groin), umbilical (belly button), hiatal (upper stomach), and incisional (resulting from a surgical scar) hernias. 

While some hernias cause minimal discomfort, others require hernia repair surgery to prevent serious complications like strangulation (loss of blood flow to the trapped tissue).  


In this comprehensive guide, we’ll cover:  

- Different types of hernia surgery (open vs. laparoscopic)  

- Recovery timeline after hernia repair

- How to prevent hernias from recurring  

- Risks and success rates


By the end, you’ll understand whether hernia surgery is right for you and how to ensure a smooth recovery.  


What Is a Hernia and When Is Surgery Needed?


A hernia doesn’t always require immediate surgery, but hernia repair surgery becomes necessary if:  

✔ The hernia is painful or growing

✔ It becomes incarcerated (stuck) or strangulated (a medical emergency)  

✔ Lifestyle changes and supportive garments no longer help


Ignoring a hernia can lead to severe complications, making timely surgical intervention crucial.


Types of Hernia Surgery


There are three primary surgical approaches, each with its own benefits and recovery process.  


1. Open Hernia Repair (Herniorrhaphy/Hernioplasty)  

A single large incision is made near the hernia site. The surgeon pushes the protruding tissue back into place and reinforces the weakened area with a synthetic mesh (hernioplasty) or stitches (herniorrhaphy).  

This is best for: Large or complex hernias.  

Recovery time is 2–4 weeks for light activities and 6–8 weeks for heavy lifting.  


2. Laparoscopic Hernia Repair (Minimally Invasive Surgery)

Small incisions are made, and a tiny camera (laparoscope) guides the surgeon to repair the hernia using mesh.  

Less post operative pain, smaller scars, and faster recovery (1–2 weeks) are the benefits of this procedure.

This way is ideal for recurrent hernias or bilateral (both sides) inguinal hernias.  


3. Robotic-Assisted Hernia Surgery

This is similar to laparoscopic surgery but performed with robotic precision for complex cases.  

Enhanced 3D visualisation is useful for the surgeon.

Recovery is Comparable to laparoscopic repair.  


Your surgeon will recommend the best type based on hernia size, location, and your overall health.


Hernia Surgery Recovery Timeline


First 24–48 Hours After Surgery

- Pain management is of prime importance. Prescription or OTC pain relievers would work.

- Activity: Rest, but walk short distances to prevent blood clots.  

- Diet: Start with liquids, then progress to soft foods.  


1–2 Weeks Post-Surgery

- Driving: Usually allowed after 1 week (if off strong pain meds).  

- Work: Desk jobs can resume in 1 week; manual labor may require about 4 weeks.  

- Avoid: Heavy lifting, straining, or intense exercise. Although it may feel too exaggerated, usually patients are advised not to lift a weight more than a cup of tea in this period.


3–6 Weeks Post-Surgery

- You can gradually return to your normal activities.  

- Physical therapy may help strengthen the abdominal muscles.  

- Follow-up visit to surgeon to check the wound healing progress.  


Long-Term Recovery

- Full recovery takes 3–6 months for strenuous activities.  

- Scar tissue softens over time.  


How to Prevent Hernia Recurrence


Even after surgery, hernias can return. Following these hernia prevention tips would reduce the recurrence rates.


1. Strengthen Your Core

- Practice low-impact exercises (e.g., swimming, Pilates).  

- Avoid sit-ups or heavy weightlifting initially.  

- Check out my article on Best abdominal exercises post hernia surgery: a safe recovery guide to see what are the safe ab exercises you can do post hernia surgery.


2. Maintain a Healthy Weight

- Excess weight increases abdominal pressure.  


3. Avoid Straining

- Use proper lifting techniques (bend at the knees, not waist).  

- Treat chronic coughs or constipation (they increase hernia risk).  


4. Follow Post-Op Instructions

- Wear an abdominal binder if recommended.  

- Attend all follow-up appointments.  


Risks and Complications of Hernia Surgery


While generally safe, potential risks of hernia surgery include: 

- Infection (redness, fever, pus – requires antibiotics).  

- Nerve damage (numbness or chronic pain).  

- Mesh rejection or adhesion (rare but may need revision surgery).  

- Recurrence (5–10% risk, higher without mesh).  

Choosing an experienced hernia surgeon minimises these risks.


What are the Non-Surgical Alternatives? (When Surgery Isn’t an Option)


For high-risk patients, alternatives include:  

- Watchful waiting (for small, asymptomatic hernias).  

- Truss (hernia belt) – temporary relief but not a cure.  


Most importantly it is noteworthy to remind you that these don’t fix the hernia—only surgery can fully repair it.


Frequently Asked Questions (FAQs)


1. How long does hernia surgery take?

- Open repair: 30–60 minutes.  

- Laparoscopic: 45–90 minutes.  


2. Will I need general anesthesia?

Most laparoscopic/robotic surgeries use general anesthesia; some open repairs use local anesthesia.  


3. When can I exercise after hernia surgery?

- Light walking: Day 1

- Gym/running: 4–6 weeks (with surgeon’s approval).  


4. How successful is hernia surgery?

90–95% success rate with mesh; slightly lower without.  


5. Can hernias heal without surgery?

No—they only worsen over time. Surgery is the only permanent fix.  


Final Thoughts: Is Hernia Surgery Right for You?

If you have a painful, enlarging, or trapped hernia, surgery is often the best solution. Modern techniques like laparoscopic and robotic hernia repair offer quicker recoveries and minimal scarring.  

Consult a general surgeon to discuss your options. Early intervention prevents complications like bowel obstruction or tissue death.  


Good luck!

From Dr. Pasindu

Stay happy stay healthy!

 

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Carpal Tunnel Surgery: When Is It Necessary? A Surgeon’s Guide


Carpal Tunnel Surgery: When is it Necessary? Photo by Viktors Duks

Today I want to talk to you about another common surgical ailment. 

Carpal tunnel syndrome (CTS) is a common condition that causes pain, numbness, and tingling in the hand and arm. 

It occurs when the median nerve, which runs from the forearm into the palm, becomes compressed at the wrist. 

While non-surgical treatments like braces, medications, and steroid injections often help, carpal tunnel surgery may be necessary in severe or persistent cases.  


In this article, we’ll explore:  

- What makes carpal tunnel surgery necessary

- The different types of carpal tunnel release surgery  

- Recovery time after carpal tunnel surgery

- Risks and success rates  

- Non-surgical alternatives  


By the end, you’ll have a clear understanding of whether carpal tunnel release surgery is the right choice for you.  


What Is Carpal Tunnel Syndrome?


The carpal tunnel is a narrow passageway in the wrist made up of bones and ligaments. The median nerve and tendons pass through this tunnel. 

When swelling or inflammation narrows this space, pressure on the nerve leads to carpal tunnel syndrome symptoms, including:  

- Numbness or tingling in the thumb, index, middle, and ring fingers  

- Weak grip strength  

- Pain radiating up the arm  

- Nighttime hand discomfort that disrupts sleep  


If left untreated, CTS can lead to permanent nerve damage and muscle wasting.  


When Is Carpal Tunnel Surgery Necessary?

Not everyone with CTS needs surgery. Doctors typically recommend carpal tunnel release surgery when:  

1. Non-Surgical Treatments Fail

Before considering surgery, most patients try:  

- Wrist splinting (especially at night)  

- Anti-inflammatory medications (NSAIDs)  

- Corticosteroid injections to reduce swelling  


If symptoms persist after 6-12 months of conservative treatment, carpal tunnel surgery may be necessary.  


2. Severe Nerve Compression (Confirmed by EMG/NCS)

An electromyography (EMG) or nerve conduction study (NCS) can measure how badly the median nerve is compressed. 

If results show severe nerve damage, surgery is often the best option to prevent permanent weakness.  


3. Muscle Weakness or Wasting

In advanced cases, patients may notice:  

- Thumb muscle atrophy (shrinking of the thenar muscles)  

- Difficulty gripping objects (e.g., dropping cups or keys)  

These signs indicate significant nerve damage, making carpal tunnel release surgery urgent.  


Types of Carpal Tunnel Surgery


There are two main surgical techniques:  

1. Open Carpal Tunnel Release (OCTR)

- A small incision (about 2 inches) is made in the palm.  

- The surgeon cuts the transverse carpal ligament or flexor retinaculum to relieve pressure.  

- Recovery takes about 4-6 weeks, with stitches removed in 10-14 days.  


2. Endoscopic Carpal Tunnel Surgery (ECTR)

- A tiny camera (endoscope) and instruments are inserted through a smaller incision.  

- Faster recovery (2-4 weeks) and less post-op pain.  

- Slightly higher risk of nerve injury compared to open surgery.  


Both methods have high carpal tunnel surgery success rates (85-90%).  


What to Expect During Recovery?


First Week After Surgery

- Pain and swelling are common (managed with ice and painkillers).  

- Keep the hand elevated to reduce swelling.  

- Avoid heavy lifting or strenuous activity.  


2-6 Weeks Post-Surgery

- Gradually resume light activities.  

- Physical therapy may help regain strength.  

- Most patients return to work in 2-4 weeks (desk jobs) or 6-8 weeks (manual labor).  


Long-Term Results

- Numbness and tingling will usually improve quickly.  

- Grip strength may take 3-6 months to fully return.  

- Scar tenderness fades over time.  


Risks and Complications of Carpal Tunnel Surgery


While Carpal Tunnel Surgery is generally a safe procedure, this too can have possible risks which include:  

- Infection (rare, treated with antibiotics)  

- Nerve damage (uncommon but can cause lingering numbness)  

- Scar tissue formation (may lead to stiffness)  

- Incomplete relief (5-10% of cases require revision surgery)  

Choosing an experienced hand surgeon reduces these risks.  


Related Reading Material:

Interesting Factors Influencing Wound Healing Process in a Nutshell!


Non-Surgical Alternatives to Consider


If you’re not ready for surgery, try:  

- Nighttime wrist splints which keeps the wrist in a neutral position.

- Ergonomic adjustments like adjusting the keyboard height, mouse use etc.  

- Cortisone injections that gives a temporary relief for 3-6 months.

- Physical therapy like nerve gliding exercises etc.


However, if symptoms worsen, the carpal tunnel surgery may be the best long-term solution.  

A person wearing a night time wrist splint Photo by SHVETS production


Frequently Asked Questions (FAQs)


1. How successful is carpal tunnel surgery? 

Most patients (85-90%) experience significant relief. Full recovery depends on nerve damage severity before surgery.  


2. How long does carpal tunnel surgery take?

The procedure itself takes about 10-30 minutes, usually done under local anesthesia while a tourniquet in place in your arm.


3. Will I need physical therapy after surgery?

Not always, but gentle exercises can speed up recovery.  


4. Can carpal tunnel syndrome come back after surgery?

Recurrence is rare (<5%) but possible if underlying causes (like repetitive strain) persist.  


5. When can I drive after carpal tunnel surgery?

Most patients can resume driving in 1-2 weeks if pain is controlled.  


Final Thoughts: Is Carpal Tunnel Surgery Right for You?

If you’ve tried non-surgical treatments without relief, or if you have severe numbness, weakness, or muscle wasting, carpal tunnel release surgery may be necessary. 

The procedure is quick, effective, and has a high success rate.  

Consult a hand specialist to discuss whether open or endoscopic carpal tunnel surgery is best for you. 

Early intervention can prevent permanent nerve damage and restore hand function.  


From Dr. Pasindu πŸ₯°

Stay happy stay healthy!

 

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Plantar Fasciitis: Understanding and Managing Heel Pain – Expert Advice from a Doctor

 

Plantar Fasciitis: Understanding and Managing Heel Pain – Expert Advice from a Doctor
Plantar Fasciitis: Understanding and Managing Heel Pain Photo by KoolShooters :


Today, I want to talk to you about Plantar Fasciitis, one of the most common causes of chronic heel pain. This condition can disrupt your daily activities and impact your quality of life if not managed properly.

In this article, I’ll explain what Plantar Fasciitis is, its causes, symptoms, and most importantly, the effective remedies to alleviate pain and promote healing.


What is Plantar Fasciitis?

Plantar Fasciitis is an inflammatory condition of the plantar fascia, the thick band of connective tissue that runs across the bottom of your foot, connecting your heel bone to your toes. This tissue plays a critical role in supporting the arch of your foot and absorbing the shock of walking and running.

People with Plantar Fasciitis often experience a sharp, stabbing pain in the heel, especially with the first steps in the morning or after long periods of rest. While it can affect anyone, it is most common in middle-aged adults and individuals who are highly active or stand for long periods.


What Causes Plantar Fasciitis?

The primary cause of Plantar Fasciitis is excessive strain or stress on the plantar fascia, leading to small tears and inflammation.

Here are some common contributing factors:

 

  1. High-Impact Activities

Activities such as long-distance running, ballet dancing, or jumping sports place significant stress on the plantar fascia, making athletes prone to this condition.

 

  1. Prolonged Standing or Walking

Jobs requiring long hours on hard surfaces, such as factory work or teaching, increase the strain on your feet, leading to inflammation.

 

  1. Obesity or Excess Weight

Carrying extra weight puts additional pressure on the plantar fascia, increasing the risk of injury.

 

  1. Tight Calf Muscles or Achilles Tendon

Limited flexibility in the calf muscles or Achilles tendon can heighten the tension in the plantar fascia.

 

  1. Inappropriate Footwear


Wearing shoes that lack proper arch support, cushioning, or are worn out can exacerbate the strain on your feet.


Symptoms of Plantar Fasciitis

 

  • Sharp pain in the heel: Particularly noticeable during the first steps in the morning or after sitting for a while.

 

  • Pain after activity: Discomfort may subside during exercise but return afterward.

 

  • Swelling or tenderness: The bottom of the heel may feel tender to touch.

 

  • Gait changes: Altering how you walk to avoid pain can lead to secondary problems in the knees, hips, or lower back.

 


Doctor-Recommended Remedies for Plantar Fasciitis

If you are experiencing heel pain, here are evidence-based remedies to alleviate the discomfort and promote healing:

 

1. Maintain a Healthy Weight

 

Excess weight increases the load on your plantar fascia. Losing even a small amount of weight can significantly reduce the stress on your feet.

 

2. Perform Regular Stretching Exercises

 

Stretching your plantar fascia, Achilles tendon, and calf muscles can ease pain and improve flexibility.

  • Example: Sit with one leg crossed over the other, grab your toes, and gently pull them toward your shin. Hold for 30 seconds and repeat.

 

3. Use Ice Therapy

 

Cold therapy helps reduce inflammation and provide quick relief.

  • Pro tip: Freeze a plastic water bottle, place it on the floor, and roll it under your foot for 15–20 minutes, 2–3 times a day.

 

4. Switch to Low-Impact Activities

 

High-impact exercises like running can aggravate Plantar Fasciitis. Consider switching to activities like swimming or cycling to maintain your fitness without stressing your feet.

 

5. Use Night Splints

 

Night splints gently stretch the plantar fascia and Achilles tendon while you sleep, helping reduce morning pain.

 

6. Massage Your Feet

 

Massaging the affected area improves blood flow and relieves tension. You can use your hands or a foot massage roller. If you prefer, invest in a foot massager device for added convenience.

 

7. Wear Supportive Footwear

 

Proper footwear is crucial for managing Plantar Fasciitis.

  • Avoid high heels or worn-out shoes.
  • Look for shoes with arch support and cushioned insoles specifically designed for Plantar Fasciitis relief.

 

8. Physical Therapy

 

A physical therapist can guide you through specific exercises to strengthen your foot and lower leg muscles, improving stability and reducing symptoms.

 


Preventing Plantar Fasciitis

 

Prevention is always better than cure. Follow these tips to avoid recurring heel pain:

  • Invest in high-quality, supportive footwear.
  • Incorporate regular stretching into your daily routine.
  • Use shock-absorbing insoles if you stand or walk for long hours.
  • Gradually increase the intensity of your exercise routine.

When to See a Doctor

 

If your pain persists despite home remedies or worsens over time, consult a healthcare professional. Advanced treatments such as custom orthotics, steroid injections, or shockwave therapy may be necessary for severe cases.

 


Conclusion

 

Plantar Fasciitis can be debilitating, but with the right care and lifestyle adjustments, it is entirely manageable. By maintaining a healthy weight, wearing supportive footwear, and incorporating stretching and massage into your routine, you can significantly reduce your heel pain and prevent recurrence.

Remember, early intervention is key. If you’re struggling with persistent heel pain, don’t hesitate to seek medical advice. Your feet deserve the best care to keep you active and pain-free!

Feel free to share your experiences or ask questions in the comments below. Together, we can tackle Plantar Fasciitis and enjoy healthier, happier feet!

 

Good luck!

From Dr. Pasindu

Stay happy stay healthy!

 

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