Scared of Surgery? How Modern Surgery Has Changed Everything

Thinking about surgery can feel overwhelming—but it doesn’t have to be.

In this episode of Baptist Health Talk, Dr. Juan Carlos Verdeja, Chief of General Surgery, breaks down what general surgeons actually do—from treating hernias to removing gallbladders—and what recovery really looks like today.

Thanks to modern techniques like laparoscopic and robotic surgery, procedures are less invasive, recovery is faster, and patients are back to their normal lives sooner than ever.

We cover:

•  What general surgeons treat 
•  Common conditions like hernias and gallstones 
•  When to seek medical care 
•  What recovery really feels like 
•  Debunking common myths about surgery 

🎧 Listen and feel more informed, prepared, and confident about your care.

Host:
Sandra Peebles
Award-Winning Journalist

Guest:
Juan Carlos Verdeja, M.D.
Chief of the General Surgery Division 
Baptist Health Medical Group
Affiliate Dean, Professor of Surgery & 
Director of Laparoscopy and Minimally Invasive Surgery,
FIU Herbert Wertheim College of Medicine

Transcript

SPEAKER_00 0:00

I think that people are scared of surgery because, you know, they're thinking about the old big slashes and cuts. I think with today's world, because of the robotics, because of the laparoscopy, we're doing much uh smaller, smaller surgery. The actual surgery is the same thing, but how we get to it is easier. And I think a lot of the recovery has to do with that.

SPEAKER_01 0:18

Welcome to Baptist Health Talk, a podcast on all things healthcare, powered by Baptist Health South Florida, your trusted source for healthcare prevention and wellness.

SPEAKER_02 0:28

Hi, everyone. I'm your host, Sandra Peebles, and welcome back to another episode of Baptist Health Talk, where we answer your most searched questions on today's trending health topics. Today we're talking about general surgery and all it encompasses, from hernias to gallbladder problems, the appendix, colon, and much more. We'll walk through what general surgeons actually treat and what recovery really looks like so that you can feel informed, prepared, and confident about your care. We're joined by Dr. Juan Carlos Verdeja, Chief of General Surgery Division with Baptist Health Medical Group. And thank you so much for being here.

SPEAKER_00 1:02

It's a pleasure to be here. Thanks for having me.

SPEAKER_02 1:03

I have tons of questions for you. So let's get right into it. When we speak about general surgery, it sounds, well, just that very general. So what are the organs that you actually treat and what are the treatments or or procedures that you perform most commonly?

SPEAKER_00 1:20

Okay. So general surgery, unlike what you think, when you say general, you're thinking general medicine, which is a very broad topic, but it doesn't have any specialty. General surgery is a specialty, and it's actually a five-year training in order to become a general surgeon. And general surgery, I like to say it's the treatment of the soft and squishy stuff. And basically, if it's not the brain and it's not the heart and it's not bones, it pretty much falls into what we do. And that can encompass everything from thyroid surgery to breast surgery to abdominal surgery, which is what we probably do the most, to lumps and bumps on your skin. Something as simple as sebaceous cyst or a mole we take care of, something as complicated as a big operation of a liver transplantation also falls within what is the realm of general surgery. Having said that, there are within general surgery other specialties that fall, subspecialties, as we call them, where people do a little bit more of certain types of work and therefore they tend to be the ones performing that, such as the transplant surgeons, for example. But what we do generally as general surgeons is a lot of abdominal surgery, uh, such as gallbladders, hernias are probably the two most common procedures, but we do colon surgery and other procedures in the abdomen and of all types of intestinal surgeries, including surgery for weight loss. So there's a lot of different things that we cover. Uh, and it's hard to, you know, to broadly define everything, but it certainly is, as I said, soft and squishy stuff.

SPEAKER_02 2:45

Well, there's a lot going on in that abdomen. So certainly it is a very broad area to be specialized in. How does someone become a general surgeon? What is the path to training and how does it differ from other surgeons?

SPEAKER_00 2:57

All right. So general surgery is a uh is a five-year postdoctorate uh training. So you basically go through the usual steps of pre-medicine, end up in medical school, do your four years of medical school, and then you go through your internship and residency where you spend five years training in all aspects of care from the simple skin structure things to trauma care for gunshot wounds and everything. I trained at the Jackson Memorial Hospital where it was in the days of the uh Miami riots and the days of the cocaine wars. So we did a lot of uh a lot of trauma medicine, but we also do a lot of training in all the different areas of the abdomen, such as hernia surgery and gallbladder surgery specifically, which are the two areas that we tend to focus the most on.

SPEAKER_02 3:44

When when you get a patient, normally how does a patient get to you? Do they get to you through a referral? Is it because they have so many symptoms? Or how is it that they find their way to a general surgeon?

SPEAKER_00 3:55

Well, the problems are the same as how they occur. So very frequently, for example, I have in my office, I see patients uh twice a week. They're coming in uh with symptoms that are things like I have intermittent pain on my right side with certain fatty meals, and what is essentially a gallbladder problem. And or they'll show up in the emergency room holding their right side, vomiting, saying, Oh my God, I have terrible pain. It's the same problem, but it's presenting two different ways. So we do have a lot of elective surgery, which is planned. Um, it's elective because we don't have to do it immediately, but a great part, probably about 60 or 65% of general surgery occurs as an emergency, where people are in the emergency room because of acute pain with appendicitis, with a perforated bowel, with an acute gallbladder attack, with uh an acute infection that they need surgery for. So we do a lot of surgery that comes through the emergency room.

SPEAKER_02 4:50

It always feels like everything that happens in the abdomen is such a mystery. It could be this, it could be that. Um, so it seems like it would be it would be challenging, but I guess that you have a lot of diagnostic uh Yeah, in today's world, we fortunately have a tremendous amount of equipment and technology and experience.

SPEAKER_00 5:03

Exactly. So we have CAT scanners and MRIs and everything else that help us find what we're looking for.

SPEAKER_02 5:08

So a cardiac surgeon obviously deals with the heart, a neurosurgeon deals with the brain. Um, but the word general is a very broad term. Um so it's a wide range of different procedures and and and conditions. What makes general surgery distinct from others?

SPEAKER_00 5:26

It's different because it is so broad, but it is a very physiological. And what I mean physiological has to do with how the body works. So a lot of what we do is is about how the body works. When you eat, what happens? Uh, and how do, if we have to do surgery, or we have to remove a piece of the stomach, or we have to, we have to reconstruct it so that it works properly. Because when you eat, you have to have certain processes that help you digest the food. So there's a lot of a lot of what we do is very geared towards functionality of the individual and recovery based on that.

SPEAKER_02 5:56

Hernia are one of the most searched topics online. What exactly is a hernia? And what are some of the common signs that indicate that it's time to see a doctor?

SPEAKER_00 6:06

All right. So a hernia is very interesting. I usually like to use a trash can to describe it. Interesting. The students will all talk about my trash can talk. Um, and basically, if you think of a trash can, the outside of the trash can gives a shape and form, but the trash can is in a plastic bag that's inside. The abdomen has the muscles that create that outside shape, but it has a bag inside called the peritoneum. All of your intestines and everything are in there. Now, if you were to cut a hole in the outside of the trash can and step in the trash can, that plastic bag would pop out through that hole. Well, that's the hernia. In the abdomen, you have a small hole that allows that sac inside to pop out. What happens is what pops out can be just fat, but it can be a piece of intestine, and that's where it's dangerous.

SPEAKER_02 6:54

So is that hole because the muscles are kind of like this and then it would open, or is there a perforation or does it have to be an injury?

SPEAKER_00 7:00

Typically, it is just a weakening of tissue. And that's that brings up interesting points about how hernias form. So that's that's one of the things that often is at this point misunderstood. So hernias, uh, from we've always been taught that hernias happen because you lifted, I lifted something heavy and it popped out. Well, yeah, it popped out because you lifted something heavy, but the hernia didn't form because of that. The hernia formed because some people just have a tendency to have weakness of their tissues. And you have accountants and lawyers who sit behind a desk all day and they get hernias, and then you have doc workers and construction workers that never get hernia and they're out there working every day carrying heavy loads. So it really has to do more with the individual.

SPEAKER_02 7:39

So to I'm hearing something that you're saying. If you have stronger abs, you have less an opportunity, less of an opportunity to have to do with it. I was hearing what I wanted.

SPEAKER_00 7:49

Yes, unfortunately, it's not actually the muscles that are getting damaged. It's the tissues that hold the muscles together called the fascia. So there's like a canvas that covers the muscles that holds everything together, and that's the that's what actually gets weakened. So that doesn't matter as far as the strength.

SPEAKER_02 8:06

So a lot of people think, well, if a hernia doesn't hurt, I can just keep going. Um, maybe they see it, maybe there's a protrusion. They think I could just keep going because it doesn't hurt. Is that true? Or should should someone with an obvious protrusion seek help?

SPEAKER_00 8:20

U If you have a hernia, you should speak to somebody, a surgeon and ideally a general surgeon who understands the problem. There are hernias that we can follow and we can basically observe as long as a patient isn't having pain or isn't having growth of the hernia. But there are circumstances where it is important to repair them. Um, there can be problems related to their risk in terms of incarcerating, which is what we call when a piece of intestine gets caught inside of it. Uh, and again, that's not uh an exorbitant risk in most settings, but in certain types of settings, it can be very dangerous. So you would really need, it's there's so many types of hernias. I mean, there are literally at least 15 or 16 hernias that just happen spontaneously, although we always think of the same two or three. There's a lot of other ones that that you would be surprised, um, as well as hernias that happen when you've had surgery, that you can have hernias develop there.

SPEAKER_02 9:13

So in many cases, people find the hernia because they didn't even know they had it. They go get an exam for something else and they discover it. Is there ever a time where you could just leave it alone where a doctor might determine, let's just wait and see?

SPEAKER_00 9:24

Yes, certainly. If it is something that is not significant, is not changing, and the patient is not having problems with it, you could watch it. Um, a lot of times the patient is coming in because they're having pain, because they're feeling pressure, because when they're exercising, they're feeling groin pain or they're having pain in their belly button. So most of the time when we do see patients electively where they show up in the office to discuss it, it's because of that. They've identified and they're not sure what's wrong. They just felt something. They went to their primary care doctor, the primary care doctor examined them, said, Hey, I think you have a hernia, and then they end up sending the patient to us for evaluation and discussion as to what's appropriate for them. Sometimes we have older patients who just aren't good candidates for surgery. And then in those cases, we'll, you know, we may choose to watch them. There's a lot of different ways to do surgery nowadays. Uh, the world changed in around 1990 with the advent of laparoscopic surgery. So we do a lot of the hernia repairs nowadays with robotics and laparoscopy, and at this point becoming the preferred way to do it. And that has changed the landscape in terms of the recovery and what we can do for patients. So it's been a big improvement.

SPEAKER_02 10:28

So you do both. You do laparoscopic, robotic, and you can also go back to the old days. You used to operate, you used to open people up. Which way do you prefer personally?

SPEAKER_00 10:38

Frankly, if it can be done laparoscopic or robotic, it's definitely a better recovery for the patient. But there are circumstances where the abdominal wall is uh needs to be reconstructed or needs to be pulled back together in a different way. So what's very important as a surgeon is to have all of the tools available. You can't always do the same thing the same way. So, you know, you can't pull your you can't pull a boat with a with a little car, but maybe the little car is more efficient for your everyday drive. So there are different ways to do things, and I think we have to use what we have, and and the knowledge of that comes with somebody who has the right training.

SPEAKER_02 11:13

What does recovery look like for a person that undergoes surgery? How soon can they get back to work and their daily activities?

SPEAKER_00 11:19

So, with regard to hernia surgery, you're looking usually at outpatient surgery. You go in, have surgery, and go home the same day almost every time. Incredible. Um, usually a couple of days. I always tell people to stay home for the first couple of days and put some ice on the wound and lick their wounds up and around, not in bed. The worst thing we ever do is stay in bed. And then to um and then within by the third or fourth day, they're driving and they're taking care of their daily needs without heavy lifting, et cetera.

SPEAKER_02 11:46

Did you just say the worst thing you could do is stay in bed?

SPEAKER_00 11:48

Yes, absolutely.

SPEAKER_02 11:49

You need movement after surgery is a critical for the blood flow?

SPEAKER_00 11:52

Yeah, it's critical for blood flow, for breathing, for intestinal activity, uh, even for the muscles themselves to get circulation through them. So it's a very beneficial uh thing to do.

SPEAKER_02 12:03

That's so interesting because there was a time where we thought if you had surgery, you're gonna be laid up for for days or weeks, and that's not the case uh any longer. That's quite incredible. Um there's a big fear for a lot of patients that they'll never be able to exercise again, that they won't be able to lift weights, that they won't be able to do things that that they used to do before the surgery. How how much truth is there to that?

SPEAKER_00 12:24

Absolutely untrue. The majority of patients by four to six weeks are completely healed, and actually the tissue has excellent strength depending on the repair and what exactly was done. And usually in today's world we do use mesh, which reinforces the repair. Uh, most patients can resume a completely normal. I have patients who are who are uh weightlifters or in fact are competitive in weightlifting, uh, and they go back to that. Uh, and certainly people who work in industries of heavy lifting go back to all that activity without restriction.

SPEAKER_02 12:53

Okay, let's switch to another organ. Okay. Because that hernia conversation was fascinating. But let's talk about the gallbladder. I know that's one of the most uh common surgeries perhaps that you perform. Uh, what does the gallbladder actually do? And what symptoms, what do symptoms look like?

SPEAKER_00 13:06

Okay, so gallbladders are there as little storage tanks. And what they do is they hold bile, which is a liquid that the that the liver makes, uh, in between your meals. So your liver makes bile 24-7, it passes it into the intestine through a tube, and hanging off of that tube, there's this little pear-shaped organ called the gallbladder. It simply stores about 15% of that bile on a running basis. When you eat foods, particularly fatty foods, the stomach recognizes the fat and sends a signal to the gallbladder says, Hey, got French fries coming. I need more bile. The gallbladder then squeezes, and that helps to increase the amount of bile to help digestion. What ends up happening with patients with gallbladder problems, it's usually gallstones, is that they form stones inside the gallbladder. And when that gallbladder tries to squeeze, they get pain from that. Initially, and most of the time, it's just a gnawing discomfort under the rib cage, but every so often a stone gets stuck. And when the stone gets stuck, it's severe pain. And it can then progress to literally an infection of the gallbladder and it becomes an emergency surgery. So a lot of people will come to the office with this gnawing discomfort when they eat fatty foods typically. Uh, after meals, they get a lot of bloating, a lot of fullness, a lot of gas because they're not digesting properly. And the gallbladder is part of that process.

SPEAKER_02 14:24

Quick question: Does the gallbladder differentiate between the fat and an avocado or nuts? In other words, good fat, salmon, or french fries?

SPEAKER_00 14:33

I get this all the time where patients tell me, but I don't understand. I eat so healthy. I don't I eat, and and I said, Let me guess, you have olive oil, avocados, and salmon. They go, yes. And I go, that's great for your heart, but it's terrible for your gallbladder. For your gallbladder, oil is oil. It doesn't matter where it comes from.

SPEAKER_02 14:50

So moderation again. So moderation.

SPEAKER_00 14:52

And what you're doing is that it's a good fatty foods to avoid the symptoms, but it doesn't take away the stomach.

SPEAKER_02 14:56

Sure, sure. Um many people think that the gallbladder attacks only happen after eating certain foods. Is that a myth? Are there certain foods that trigger it? Certainly.

SPEAKER_00 15:05

Yes, certainly fatty foods will trigger the gallbladder. Uh so that is what is most symptomatic, but honestly, you know, simple. Everything in life, everything you eat has some fat in it. It's almost impossible to eat a fat-free diet. I've tried. So it is not good. Because I can tell you, I'm I'm what is it they say? I'm I'm not just the president, I'm a client. Yeah. I've had my gallbladder removed. Oh, really? So I know all about this from inside out. What a claim to fame.

SPEAKER_02 15:31

Um, no, but I think that we need fat in our diet, of course, for certain things. It's just not moderation. That's what sometimes is difficult, is for us to moderate ourselves with all of our habits and our and our desires, not what we want to have. Um, many people push through the pain of gallbladder and thinking, I can handle this. Is that a horrible idea?

SPEAKER_00 15:51

The reality is that if you're having symptoms and you keep pushing it, you're only you're only suffering needlessly because it is likely that you will end up having surgery and you might delay maybe a year or two or five, uh, but you end up then having an emergency surgery a lot of times. Uh, or worse, there are complications if you have small stones that go into the main tube from the liver to the intestines, and you can get pancreatitis or other much more severe problems.

SPEAKER_02 16:17

Of course, it's always better to have to organize and be planned and have a surgery where you're planned and you know it's coming and you can prepare yourself for it psychologically, even and have your family. Time wise, right?

SPEAKER_00 16:27

Inevitably the bet big bad attack happens when you're on vacation somewhere or or right before you're leaving somewhere. So absolutely.

SPEAKER_02 16:36

Deal with things. Uh so if someone needs to have their gallbladder removed, are they still able to digest food? Like how do we survive without a gallbladder?

SPEAKER_00 16:43

All right. So the gallbladder assists with digestion, but it's not the critical part of digestion. The critical part is the bile. So what happens is the body will adapt. That little that tube I talked about that goes from the liver to the intestine will simply get bigger. It will dilate and hold more bile. The liver will produce the same amount of bile anyway, but now since it doesn't have where to store it, it will then dilate the tube to make it store it in there. So basically, it's a great compensation. Most patients do very, very, very well uh after the gallbladder surgery. Uh and it is the most common operation performed in this country. Close to a million people a year in this country have their gallbladder taken out.

SPEAKER_02 17:20

So one thing that people uh search quite a lot on the internet is is this a major surgery or is this a routine surgery? And I think you've answered that.

SPEAKER_00 17:29

Yeah, I mean, I think it is very, very common, like everything. We don't, it's like when you go out, if you have a boat and you go out in the water or you go swimming, you always think, you know, it's a safe activity, you do it all the time, and you take the appropriate precautions. Can things go wrong? Absolutely. But generally speaking, it's a very safe operation, it's less than 1% risk of complications, and most people recover very, very quickly. Uh the gallbladder surgery, and for most people, done laparoscopically or robotically, you're talking really about two to three days of discomfort, followed by maybe a week of tiredness, uh, but you're back right away.

SPEAKER_02 18:03

Let's talk about scars and downtime.

SPEAKER_00 18:06

Scars are very small. Again, laparoscopically, you're talking about scars that are a quarter of an inch to half an inch in size. Uh, the downtime really has to do with the recovery in terms of heavy lifting. Um, I've had gallbladder patients who call me on day two or day three and are going back to work. Uh, you know, that's not unusual. I myself was back at work in three days. Uh, but I'd say most people take a week just from routine. Now, the other problem is eating. Everybody goes into a panic. I don't have my gallbladder. Now, so you get two things. If you do read the internet, you're gonna see every blog on the planet about diarrhea after surgery for the gallbladder. That's because the 10% of people who have the problem write all the blogs. The reality is 80 or 90% of people never have a problem with their diet after surgery. And in fact, as I tell people, I don't have a gallbladder, I eat masita de puerco, vaca frita, and pizza all the time.

SPEAKER_02 18:58

In moderation, I'm imagining.

SPEAKER_00 19:00

Like I'm not telling people to eat poorly. I'm just telling them it's okay to eat what they usually eat.

SPEAKER_02 19:05

What about gas after surgery?

SPEAKER_00 19:07

Gas at the beginning actually tends to be a little worse as your body adapts, but once your body's adapted, it tends to improve.

SPEAKER_02 19:13

So uh general surgery covers so much, right? From emergency situations to planned procedures. What does that balance look like in real life? And do most surgeons or general surgeons end up finding this niche that they're passionate about by chance?

SPEAKER_00 19:27

Yes. So what happens is again, we do, as I said before, thyroid surgery, we do parathyroid surgery, we do breast surgery. So you'll now see general surgeons who do only breast surgery or do only thyroid surgery or do only nobody abdominal. I think everybody that gets into that world really likes it. I think most surgeons like myself enjoy the variety, so to speak, and we like the challenge of all of that that has to do with. Um, we also do things, for example, like weight loss surgery, uh, which is done by operating the intestines and the stomach to reduce the size of it or to reroute it so that, again, it's a physiologic, how the body works thing, and you can maneuver, you know, with the way you re-circuit the bowels to lose weight. Uh, you have colon surgery, which is important for people like diverticulitis, which is extremely common. You also have it, obviously, for colon cancer. Uh, and then there's a whole slew of additional procedures that have to do with cancers of different types that general surgeons take care of.

SPEAKER_02 20:22

And that diverticulitis is so common, but it's also deadly if it's not taken care of, isn't that so?

SPEAKER_00 20:27

Diverticulitis can perforate. And if it perforates, that is a very serious life-threatening situation. Uh, so yes, people that have diverticulitis are usually under the care of a gastroenterologist or their primary care doctor, but if they're having repeated bouts, that's the reason to have surgery, or if they've had a contained perforation at some point. Usually we get involved in the hospital because we get called in to see patients like that at the time of their acute admission, and then we'll talk to them and explain to them what their options are.

SPEAKER_02 20:56

What would you like anyone listening to this program now that maybe has to have a surgery? What do you want them to leave with? What information, what do you want them to know as far as the safety, the recovery of a surgery that they might have to undergo?

SPEAKER_00 21:08

So I think the most important thing is to lose your fear. You don't know how many times I hear from patients, I should have done this five years ago. I should have, you know, they said, I feel so much better now. And if I had known it was going to be like this, I would have taken care of it. So people that have small hernias, let them become big hernias, which then increases their recovery. It makes it worse. I think that people are scared of surgery because, you know, they're thinking about the old big slashes and cuts. I think with today's world, because of the robotics, because of the laparoscopy, we're doing much uh smaller smaller surgery. The actual surgery is the same thing, but how we get to it is easier. And I think a lot of the recovery has to do with that. I think most people will will find that that they should explore, you know, their options and and really you find that that it's gonna be a really significant. Improvement and change in their life at very little cost at the end of the day.

SPEAKER_02 22:04

It this has been such an exciting conversation, really. And if I had any fear of surgery, which I tend to be pretty um not fearful about these things, uh I would I would definitely have gotten over it with the conversation. Thank you so much for the confidence you're instilling in our in our viewers and for the work that you do. Thank you so much for being here. And this has been a great conversation. Uh remember, viewers, be sure to hit that subscribe button on your channel here to keep up with the latest health and wellness information and tips from our experts. Thank you so much for watching.

SPEAKER_01 22:33

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