You have just undergone laparoscopic umbilical or ventral hernia repair. This usually involves making small incisions on the side of your abdomen and one over the hernia. Your abdomen is then inflated with a gas and the hernia is patched on the inside with mesh. The mesh is held in place with tacks that are placed around the edge of the mesh as well as in an inner ring around your hernia. This type of repair always requires general anesthesia and local numbing medicine is also used.
Soreness and pain throughout the abdomen is normal after surgery. You may feel pain in spots further away from the hernia than you expected – this is due to the tacks that hold the mesh in place all the way around the edge of the mesh. This is normal and will get better with time. Pain will be worse with movement, changing positions from laying to seated to standing. This is normal and will go away over time.
Additionally, pain can extend into the shoulders – this pain is due to a small remaining amount of gas within your abdominal cavity. This gas was used to inflate your abdomen in order to do the surgery. While we try to vent all of this gas out at the end of the surgery it is impossible to get all of it out. This small amount of gas causes some irritation of the lining of the abdominal cavity and our brain sometimes translates this to pain in the shoulder. The gas dissipates on its own over 24-48 hours and nothing needs to be done. It will get better!
Most of our patients take only Tylenol and ibuprofen for pain management after surgery. If you have been advised in the past not to take one of these medications, please follow those instructions. Applying ice to the surgery site for 20 minutes at a time can also be helpful.
We recommend taking the following (if allowed) every 6 hours for the first few days after surgery as needed:
If you are experiencing significant pain that is preventing you from going on a walk or falling asleep, please call the office to discuss prescription pain medications. Opioid pain medications like oxycodone, will cause constipation, so we recommend following the instructions below for constipation.
The incisions are closed with dissolvable sutures – these do not need to be removed.
You will either have surgical glue or a plastic bandage over your wound.
Your incisions may feel hard about 7-10 days after surgery. This is due to scar tissue, and is a normal part of healing. This hardness will eventually soften and smooth out. Bruising and swelling around the surgery site is also normal and will resolve with time.
Some patients will feel a firm lump in the area where their hernia used to bulge. Most of the time this is fluid in this area – called a “seroma” – this will resolve within a few months.
Many patients have used Arnica Montana, either as a gel or orally, to reduce swelling and bruising after surgery. Arnica is a safe, homeopathic medicine that works well in many patients. Most natural food stores will carry it.
You may shower at any time after surgery. There is either waterproof glue which can be left alone until the glue falls off around 2 weeks or a waterproof bandage over your incision. Once this bandage is removed (48 hours after surgery), you can continue to shower with the steri-strips over the incision. You do not need to put a new dressing over the top.
Please avoid baths, hot tubs, pools, or soaking in water for 2 weeks after surgery, as this can increase your risk of an infection.
Following surgery, you are encouraged to do as much walking as is comfortable. You may climb stairs, taking them one at a time and slowly. We recommend walking at a leisurely pace for the first 2 weeks.
Avoid exercise, strenuous activity, lifting over 25lbs, and repetitive actions for 2 weeks after surgery. After 2 weeks, you may slowly resume these activities, but do so slowly and progressively, and listen to your body if it is telling you to stop or slow down.
You may drive 24 hours after surgery if you feel up to it, as long as you are not taking any prescription pain medications. We typically recommend you avoid driving for 48-72 hours unless necessary.
Although not commonly seen, any incision is susceptible to infection. If you develop a fever of 101 degrees or above, have unexpected pain, redness or pus draining from the incision, please contact our office.
Your pain and swelling should gradually improve after the second or third postoperative day. If you have new, constant pain after feeling good for a couple of days, please contact our office.
You will have a post-operative appointment scheduled between 3 and 5 weeks after surgery. If you do not see this scheduled, or if you need to reschedule, please contact our office.
The winter months bring lots of colds and sometimes the flu. If you find yourself needing to cough or sneeze, it’s often helpful to place a pillow or your hand over your incisions. This provides some support and comfort, and will hopefully decrease your pain when you cough or sneeze. Sharp pain is not uncommon after a cough or sneeze, and lingering effects should resolve in a day or two. It’s very unlikely that the hernia will return as a result of this.
DOWNLOADABLE LAP UMBILICAL HERNIA REPAIR POST-OP INSTRUCTIONS
The above information is provided for educational purposes only. This information is not intended as a substitute for professional evaluation by an experienced surgeon.