Post-Operative Instructions for Laparoscopy

What will my recovery be like?

One of the main benefits of laparoscopic surgery is that there is less pain than an open procedure. However, you will still need pain medication for a few days.

In the recovery room

In the recovery room, you will be given pain medication through the IV. Once you are awake enough to take pain medication by mouth, you will be given pills for pain control.

Typically, patients need narcotic pain medication for the first one to three days. Gradually, the need for the narcotic pain medication decreases over time. By the fifth day after surgery, it is very unusual for patients to need narcotic pain medication.

You will be asked to get up and walk within 2 to 6 hours after surgery. Early walking has been shown to speed recovery and decrease complications such as pneumonia or blood clots. Moving around will be somewhat painful at first. This is normal. Most patients say they are comfortable at rest, but when they sit up it hurts. This is normal. Pain medication is used to reduce the pain so you can walk.

The pain is related to the incision. The larger the incision, typically the more pain a person will have. The laparoscopic incisions are small, so the pain is less, but you will have some pain. However, each day, the pain should be less and the more you walk, the more quickly the pain will go away.

At home

Dr. Willman will prescribe you pain medication for home. You will receive this prescription at your pre-op visit. Every patient is different in their need for pain medication. During your pre-operative appointment, Dr. Willman will talk to you about your experience with other surgery, other experiences in which you have had pain and past experience with pain medication. This will help guide her in deciding what pain medication you need and if anything additional needs to be done for your recovery.

Several steps are taken to minimize your pain from your procedure: use of pain medications before surgery and of local anesthetics during surgery. Sometimes there can be a bit of trial and error in finding the right combination or type of medication that helps you.

One aspect of pain that is unique to laparoscopic surgery is shoulder pain. Shoulder pain can occur due to carbon dioxide gas that is used during the operation. Dr. Willman tries to remove all the CO2 from inside the abdomen before closing the incisions, but sometimes a bit is left behind. In the abdomen, it can irritate the diaphragm and the result is pain referred to the shoulder. The best remedy is to lie down and take your prescription pain medication. This pain will typically resolve within 24 hours as the CO2 is slowly absorbed.

Do I need a special diet after my operation?

There are no dietary restrictions. You may eat whatever is appealing to you. You simply want to avoid eating anything that might upset your stomach: start off with small amounts of relatively bland foods and adjust your eating gradually. Dr. Willman says, “it is better to start with soup than pizza!”

Are there any activities I should avoid?

  • Plan to rest at home for 3-5 days. If you have stairs in your home, it is safe to use the stairs but go slowly until you are comfortable with them.
  • Avoid lifting anything heavy (over 20 pounds) for the first week.
  • You should not drive for 5 days.
  • You should not drink alcohol or use any dangerous equipment while you are taking the narcotic pain medication.
  • You may have light vaginal bleeding over the next few days. Use a sanitary napkin, not a tampon for the first four days after your procedure.
  • It is advised not to have intercourse for two weeks after your procedure.
  • Nothing you do is going to break open your stitches or cause any serious problem. If you are too active or engage in too strenuous an activity, the risk is that you will increase your pain, which can be a setback. Simply use common sense: if it does not hurt then it is safe to do.

How do I care for my wounds?

  • Underneath the skin are stitches that dissolve over 12 weeks. The stitches do not need to be removed.
  • Over the incision will be a clear Band-Aid. This can get wet, so you can shower 24 hours after surgery. Removed the bandages in 3-4 days. Keeping them on longer can result in skin irritation, rashes and blisters so do remove them. It is actually safe to remove them as early as 24 hours if you see a blister forming.
  • On removing the Band-Aid, there will be a scab. It is safe to shower and get this wet, but do not scrub or pick at the scab. It will gradually go away. You will have a follow-up appointment with Dr. Willman one week after your operation and she will look at the incision sites to make sure they are healing well.
  • There will be firmness under the wounds and they will be purple or dark at first. It will take up to 12 weeks for the incisions to soften and lighten.   If you have concerns about keloid formation, please ask Dr. Willman about precautions for this.
  • If there is any white or yellow drainage from the wounds, redness or pain, you should let Dr. Willman know about this right away.

What symptoms should I watch for?

Contact the office is you develop any of the following symptoms:

  • Fever (temperature greater than 100 degrees F by mouth). If you do not have a thermometer at home, but you feel warm or are having chills.
  • Feeling faint, light headed, as if you were going to pass out.
  • Abdominal pain that is persistent, increasing and not relieved by the recommended pain medication.
  • Persistent heavy bleeding from the incision sites.
  • Discoloration or drainage from the incision sites.
  • Vomiting or inability to eat due to nausea.

For emergencies, call (925) 867-1800. If it is after office hours, the answering service will pick-up. Tell them you had an operation by Dr. Willman and you need to talk to Dr. Willman immediately. They will contact her.

When is my follow-up appointment?

You will be given an appointment about one week after your procedure. Your incisions will be checked for healing and any sign of infection. Any concerns can also be addressed.

At the follow-up visit, the operation will be reviewed in more detail, photographs will be reviewed and the final pathology report will be confirmed.

A second follow-up visit will be scheduled about 6 weeks after your procedure. Typically a vaginal ultrasound is done at this time to confirm healing internally. A future treatment plan will also be made with consideration of all your fertility concerns.