When can I return to work after hernia repair surgery?

First off, in answering this question, you must determine the type of hernia that you are having repaired.  Second, you need to know the general class (laparoscopic/minimally invasive or open) of repair that you had.  For our purposes here, we will divide the discussion into the two main hernia types, inguinal or ventral (which includes umbilical, incisional, and epigastric).

Inguinal hernias

Inguinal hernias are the most common type of hernia that is repaired surgically.  Traditionally, this was a big concern as it often meant up to six weeks until full recovery with several weeks off of work considered normal.  More modern techniques have, fortunately, reduced this timeline quite a bit in some cases.

Open repair

As the name implies, this technique involved making a larger incision in the inguinal (groin) region and thus “opening” up the area where the hernia is and repairing it that way.  This technique can be done both with and without mesh as a reinforcement, and has been utilized by surgeons for decades with satisfactory results. This is not a technique that we use at Surgical Associates of North Texas, however, as we feel that the laparoscopic approach is vastly superior and as such have stopped doing open inguinal hernia repairs.  The main reasons for this are that this technique has a longer recovery period, generally induces more immediate postoperative pain, and has both a higher recurrence rate (chance that the hernia could come back again in the future) and a high incidence of nerve injury resulting in chronic pain. Time off from work might be anywhere from several days to several weeks, depending on the type of job you have and the level of activity required of you.

Laparoscopic (minimally invasive) repair

Again, looking at the name, you will be able to tell that this technique is less invasive that used in open repairs.  Here, three small (less than 1”) incisions are used to place a camera and slender instruments into the area where the hernia is and repair it this way.  This technique always utilized mesh reinforcement, unlike the open repairs where some may choose not to. This is important as the usage of mesh has significantly decreased the recurrence rates for hernia repairs since its introduction several years ago.  As mentioned above, this technique has a very low recurrence rate (around 1/1000 in our practice) along with a low chance of chronic pain (around 1% in our practice). More importantly for most of our patients, however, is the shorter recover and reduced time off of work.  The technique used here is such that once the surgery is completed, then the only limitations as far as activity are based on pain tolerance, not on any specific limitations that we place on you. Once you have healed adequately and feel like it, you may resume all of your normal activity.  Typically, that means back to normal day to day activity in 24-48 hours, back to work in 48-72 hours depending on your type of work. Most of our patients will have their surgery on Friday and then be back at work on Monday without any major limitations. We’ve had patients resume full activity (including playing professional ice hockey, professional boxing, and full impact aerobics/cross-fit training) within two weeks of surgery using this technique.  In short, you can expect to get back to your “normal life” within just a few days of surgery, thus minimizing the costs caused by lost work.

VENTRAL HERNIAS

Ventral hernias include any hernia that occurs on the anterior abdominal wall.  While they can occur in lots of locations along the abdomen (umbilicus, at incision, the epigastric region) the basic premise of their repair is the same for this discussion.  As with the inguinal repairs, we will divide these into open and laparoscopic repairs.

Open repair

As with the inguinal hernias, open ventral hernia repairs also involve making an incision directly over the area where the hernia is located.  Depending on how big you are and how big of a hernia you have, this incision can sometimes be very large. If so, this may mean that you will need to spend one or two nights in the hospital after your surgery, which will obviously affect how long your recovery will take.  Assuming that you have a small defect which can be repaired simply on an outpatient basis, then you should expect at least a week, probably two before you are going to feel like returning to work. If you have a job that requires more strenuous activity, then this will be longer, closer to 6 to 8 weeks before you are cleared to resume full, unlimited activity.  With these repairs, there is a direct correlation between resuming activity too soon after surgery and the chance that the hernia will come back, making the recovery process a bit more stressful for a lot of people as they are constantly worrying that they will “screw up their repair” and need another surgery.

Laparoscopic repair

Again, as with the inguinal repairs, this technique uses small incisions and a camera to repair the actual defect.  One of the biggest advantages of this technique when talking about ventral hernia repairs is that the size of the patient and the size of the hernia (at least up to a point) have very little impact on the recovery time.  No matter what size of patient, the incisions used to place the camera and instruments are still the same, thus allowing for a quick recovery even with large patients and large hernias. The biggest difference here, when compared to the inguinal repairs, is that in order to place the mesh used to fix these hernias, the entire abdomen must be insufflated (filled with gas) which tends to cause more discomfort.  Typically it takes 4-5 days for most people to feel good enough after this type of surgery to then resume their normal, day to day activities, and usually about 7-10 days before they feel like going back to work. Our typical patient will have this surgery on a Friday, take the next week off, and then return to work the following Monday. This gives them 9 days of recovery time with only a week of work missed.  As with the inguinal repairs, however, this technique does allow you to resume activity without fear of “messing up” the repair or doing something that is going to influence how your recovery goes. As your body heals and you feel like doing more and more activities, you can do so without worrying about anything. Comfort levels again dictate how long it really takes you to get back to full, unrestricted, activity.

Regardless of the type of hernia you have, the type of repair that you choose will have major implications on how long your down time is and how long you’ll need to miss work.  If you would like more information about your hernia surgery and how it will affect you, please set up a visit with Surgical Associates of North Texas so that we can further discuss and answer any questions you might have.