Laparoscopic Hiatal Hernia/Acid Reflux Surgery

Post-Operative Instructions

If you had general anesthesia, you may feel drowsy or nauseated for a temporary period of time that may last 12 to 24 hours.

Following laparoscopic surgery, you will experience generalized abdominal pain. This is normal. You may have pain that extends to the shoulder blades and back. This is also normal and will improve over time.

Incision Care

If you have a dressing, leave it on for the first 2 days. You may take a sponge bath, but avoid a shower or getting your wound wet for the first 48 hours. After 48 hours, when you remove the dressing, you may shower. If you have small pieces of tape/glue over your incision, do not remove these, they will fall off with time. If there is no dressing you may shower after 24 hours. Avoid baths, hot tubs and swimming for the first week. If you notice any thick yellow discharge, major swelling or severe discomfort you need to call our office.

Some pain, small amounts of blood, as well as bruising, is expected. This should improve within a few days.

Diet

You may have been given more specific instructions, however you may generally follow a:

Full Liquid Diet for 2 weeks, then soft diet for 2 weeks (we will provide soft diet info at your follow-up appointment). Avoid carbonation for 1 week and as comfort allows.

Medication

Please be sure to take all medications that you usually take on a regular basis. However, it would be a good idea to avoid aspirin for five days after your operation, unless prescribed or recommended by your surgeon.

Pain medication will be prescribed for you; you may take it as needed. You should avoid driving, operating heavy equipment, or potentially hazardous garden equipment while taking narcotics. Side effects of narcotics may include nausea, vomiting, lightheadedness, rash, irritability, or fatigue. Once pain begins to subside, you may try switching to some plain Tylenol after the first day or two since you may no longer need the narcotic. This will help avoid constipation as well. Over-the-counter Gas-X (simethicone) up to 3 times a day may be helpful for bloating and discomfort.

Activity

You are to avoid heavy lifting in the first 4 weeks (nothing greater than 10 pounds). After 4 weeks you can gradually return to activity as tolerated. 

Activities such as deep breathing, walking and going up the stairs will encourage the resolution of some of the stiffness and discomfort and is highly recommended. Many people have problems sleeping after an operation. This is usually the result of too many naps during the daytime. Adequate activity should resolve this problem.

Resumption of driving is dependent on the type of procedure you have had and your level of pain and mobility―generally a few days to up to two weeks after surgery. After major abdominal surgery, it is recommended you wait until your first post-operative visit to the surgeon before initiating any driving. As always, wait to drive until common sense says it is safe to do so. You must no longer be taking narcotics, and must be able to respond physically and cognitively to any situation on the road you may encounter.

Constipation

To avoid constipation drink prune juice. Take your stool softeners (docusate) twice a day if they were prescribed. You may have a gentle laxative, such as 1-3 tablespoons of Milk of Magnesia if you have not had a bowel movement for three days.

Call the Office at (815) 717-8730

• When you return home from surgery to schedule a follow-up appointment for about 2 weeks from surgery.
• If you have bleeding from the surgical site that requires more than two maxi-pad dressing changes.
• If you are still unable to have a bowel movement after trying Milk of Magnesia on the fourth day following surgery.
  
• If you develop a fever of 101° F or 38.5° C or higher following the day of surgery. However, low-grade fevers are not unusual after abdominal surgery and should be managed with coughing, deep breathing and walking. You may use over-the-counter Tylenol (650 mg every 6 hours as needed). 
  

If you need FMLA forms completed, fax them to 815-717-8729 or you can mail or drop them off at the office.

Go to the Emergency Room:

• If you have been unable to urinate eight hours after being discharged from your surgery and have a feeling of fullness, let the tap water run to instigate urination. If you are still unable to urinate, go to the emergency room. You may tell the ER physician that you need a Foley catheter placed and will follow-up in our office the next business day.
• If you notice any unusual intra-abdominal organs protruding through your incision.
• You have uncontrolled retching or vomiting and are unable to tolerate even a liquid diet.