When can I return to work after hernia repair surgery?

We want our patients to return to work as quickly as possible after hernia surgery. There are many different ways to repair a hernia, and each of these has a different recovery.  We found that most of our patients who underwent the open pre-peritoneal repair were able to return to work in 1-3 days after surgery. This kind of fast recovery and quick return to work does not apply to every kind of hernia operation and to every patient.

Why do people return to work so fast after the Fast Recovery Hernia Surgery?

The mesh repair that Dr. Reinhorn performs is based on simple physics and basic surgical principles. In an inguinal hernia, an opening in the abdominal wall allows abdominal contents to fall out of the abdomen, often toward the scrotum. By placing a piece of mesh on the inside of the abdominal wall, between the abdominal cavity and the abdominal muscles, we rely on abdominal pressure to hold the mesh in place. This is the same principle as placing a patch inside a torn bike tire, rather than placing a patch on the outside of the tire. Since the hole in the abdominal wall is often less than one inch in size, and the patch is almost six inches long, there is a lot of overlap over the hole. The extra surface area of the mesh allows the abdominal pressures to spread evenly and hold the mesh in place. The mesh in our repair is identical in size and location to laparoscopic or robotic inguinal hernia repair. There is a critical difference when comparing what we do to traditional open mesh repairs. In the traditional repairs, a smaller mesh is placed between the layers of the abdominal wall, which can be more painful initially and takes longer to heal, as the mesh is working against the abdominal pressure. Due to this mesh placement, the abdominal pressure is always pushing against the mesh, leading to a longer recover as well as higher incidence of hernia recurrence. In addition, the mesh in a traditional repair is placed in the same area as nerves in the groin, which increases the risk for chronic groin pain after surgery. Because of the shorter recovery time, decreased risk of recurrence, and decreased risk of chronic pain, Dr. Reinhorn recommends the open pre-peritoneal mesh repair over a traditional mesh repair. In fact, the international hernia guidelines published in 2017 suggest that pre-peritoneal mesh placement and local anesthesia are the best ways to fix inguinal hernia, something we have practiced since 2004.

The second reason our patients return to work quickly after undergoing inguinal hernia repair in our practice is that we are generous with the use of local anesthetics during surgery. All of our patients are given a nerve block as well as a generous amount of short-acting and long-acting local anesthesia prior to every step of hernia surgery. By injecting local anesthetic, we make the area numb, allowing us to do almost the entire operation without a sensation of pain reaching the brain. This technique leads to less pain and inflammation after surgery, and quicker return to work and other activity.

Avoiding Opioids After Hernia Surgery

In our recent research publication, we found that over 60% of our patients did not use any opioids (narcotics) after inguinal hernia surgery. By avoiding opioids, patients were able to drive the day after surgery, and often return to non-physical work within 3 days of surgery. We typically schedule surgery for Fridays, so that patients that have desk jobs are able to recover for the weekend and return to work the following Monday. . Many of our self-employed patients tell us that they are able to return to work the day after surgery. For patients whose jobs require heavy lifting, we require taking two weeks before starting heavy lifting. Some jobs may require additional time off of work. For example, our patients who are firefighters or police officers will often benefit from 3-4 weeks to recover. For the first 2 weeks, they are not allowed to lift anything heavy or do anything strenuous. For the next 1-2 weeks, we recommend they slowly ease back into activity and lifting, so that by the time they return to work, they feel comfortable doing anything that is required of them. Overall, the decision to return to work is individualized, based on the patient’s recovery and job. We are happy to work with our patients to provide the necessary guidance and documentation for safely returning to work after hernia surgery.

What patients say about returning to work after hernia surgery

My hernia surgery went just as Dr. Reinhorn predicted…no need for serious pain medication, and normal activity in two weeks. In fact I traveled for business 3 days post surgery and was hiking the Tetons two weeks later. Highly recommend his technique.

Written on 10/6/15 – vitals.com

 

About Dr. Reinhorn

Dr. Michael Reinhorn is a specialist in inguinal hernia and umbilical hernia.  Dr. Reinhorn started his practice as a full service general surgeon in 2001. In 2012 Dr. Reinhorn started to focus on the care of hernia and pilonidal patients.   This focused practice has been designed to provid a superior clinical experience. Dr. Reinhorn has published his outcomes and continues to participate in hernia and surgery societies.  His research led to a reduction in opioid prescribing after hernia surgery. His team performs approximately 400 hernia surgeries every year.