Patient guide
A hernia hardly ever gets better on its own, but keyhole repair means treatment is usually much simpler than people expect. I'll walk you through the right timing and approach for you.
This page is general information from Dr. Jose John Maliakal, not a diagnosis. Your treatment plan is decided together at consultation.
What people usually notice
- A bulge or swelling in your tummy or groin, more noticeable when you stand, cough, or strain
- A dragging or heavy feeling, especially when lifting or standing for a while
- The bulge goes down or disappears when you lie down
- Mild aching or discomfort at the site that comes and goes
- Sometimes there are no other symptoms at all, just the bulge
- A feeling of weakness or pressure in your abdominal wall
When I would want you seen sooner
- The bulge suddenly becomes very painful, firm, and you can't push it back in, a possible sign of obstruction or strangulation
- Severe abdominal pain with vomiting, and no gas or stool passing
- The skin over the bulge turning red, discoloured, or unusually warm
- Fever together with abdominal pain and the bulge
With any of these, go to the nearest emergency department. Don’t wait for an OPD slot.
Your options
TAPP laparoscopic inguinal hernia repair
often day careTrans-Abdominal PrePeritoneal repair
This is a keyhole approach where I repair groin (inguinal) hernias using a mesh placed through small incisions. It usually means smaller scars and a quicker return to your normal activity compared with open surgery.
IPOM / IPOM-Plus repair
often day careIntraperitoneal Onlay Mesh repair
For hernias in the abdominal wall or at an old surgical scar, I go in laparoscopically and place a mesh from inside. With IPOM-Plus, I also close the defect itself for extra support where that helps.
Open hernia repair
For some hernias, or when keyhole surgery isn't the better fit, open repair is still a solid, reliable option. I'll advise you on what suits your particular hernia.
After the procedure
Everyone is a little different, and I will confirm your own plan when I see you. Broadly, this is what to expect.
Day of the procedure
Laparoscopic hernia repairs are often day care or a short stay. I'll confirm which applies to you based on your hernia and your general health.
First week
Some soreness around the cuts is normal. I'll encourage gentle walking, but ask you to hold off on heavy lifting and straining.
2 to 4 weeks
Most people gradually get back to their normal day to day and light work in this stretch, though I usually ask you to hold off on lifting a bit longer.
4 to 6 weeks
This is usually when you can think about more strenuous activity, exercise, or manual work again. I'll confirm the timing once I see how you're healing.
Good to know
Do I always need surgery for a hernia?
Most hernias are repaired surgically, because they don't fix themselves and can grow or become complicated over time. In some cases, especially with no symptoms, we can talk about watching and waiting, but that's decided after I've examined you.
What's the real difference between keyhole and open repair?
Keyhole (laparoscopic) repair uses small incisions and usually means less visible scarring and a faster return to normal activity. Open repair uses one larger incision and is still the right choice for certain hernias. I'll recommend what's best once I've seen your case.
Is mesh always used, and should I be worried about it?
Yes, mesh is a standard part of most modern hernia repairs, and it's there to add strength to the repair. I'm happy to talk you through the specific mesh and technique planned for your case.
How soon can I lift things or start exercising again?
Light activity usually comes back within days, but I'll ask you to hold off on heavier lifting and strenuous exercise for several weeks. I'll give you a timeline that fits your repair and your job.
Can a hernia come back after it has been repaired?
Recurrence is possible with any hernia repair, though modern mesh techniques are designed to lower that chance. Sticking to my advice on lifting and activity afterward really helps your healing.
What happens if I just leave it alone?
Hernias generally do not go away on their own and tend to enlarge slowly. Every so often, part of the bowel or tissue can get trapped (obstructed or strangulated), which is a genuine emergency, so a growing bulge or ongoing symptoms are worth getting checked.
Let us have a chat
If you are worried about a symptom, thinking about treatment, or you just want a clearer answer, send me a WhatsApp message and we will help you arrange a time at Thangam Hospital.
Thangam Hospital of PMRC
West Yakkara, Palakkad, Kerala 678004
OPD 9:00 AM – 4:00 PM
Please confirm the day’s OPD on WhatsApp before travelling.
After you message, we will confirm the day's OPD, help you pick a time, and tell you what to bring: any earlier reports and scans, your current medicines, and your insurance card if you have one. Please avoid sending sensitive medical reports on WhatsApp unless we ask you to.