Tips for Postoperative Care after Laparoscopy

Laparoscopic deep excision surgery is the gold standard treatment for endometriosis. Fortunately, serious postoperative complications in laparoscopy are rare. Research has also shown that long-term pregnancy rates in young women with endometriosis after a laparoscopy to treat pelvic pain are high. Below are some measures that all endometriosis patients can take in order to facilitate a smooth recovery.

Designate a support person

The first 48-72 hours after surgery are important. You will go home the same day or the day after your surgery. In order to go home, we expect you to be able to tolerate a simple diet without excessive nausea, walk, void and have your pain under control.

Once home, common symptoms during this time include mild to moderate discomfort in the abdomen, pain in the shoulder, and tiredness. Having a support person beside you during this time can be very helpful. They can facilitate daily activities, and household chores, bring you to appointments, and provide emotional support.

Give yourself a full recovery period

A proper postoperative recovery period is essential. The exact time for recovery depends on the complexity of the procedure, but it typically ranges anywhere from 2 to 6 weeks. There are some cases that will require an extended period of recovery, which your physician will discuss with you.

Each day, you should be able to notice a gradual improvement in postoperative symptoms.

Slowly increase your activities

Most patients take off at least 1-2 weeks from work for routine laparoscopy and 3-6 weeks for a hysterectomy. Depending on the job, many elect to come back at reduced hours initially and scale up as allowed.

Exercise is encouraged and ideally, by 4-6 weeks, most pre-surgery exercise and household activities will be allowed. There are some exceptions and be sure to ask your physician about heavy lifting and/or pelvic rest. You may be invited to the clinic for an additional postoperative visit after 6-12 weeks to review your recovery process.

Understanding normal postoperative symptoms

As with any surgical procedure, common symptoms after laparoscopy include:

• Light vaginal bleeding or spotting up to 1-2 weeks
• Mild to moderate tenderness in the abdomen
• No bowel movement for several days postoperatively
• Shoulder pain
• Fatigue
• Nausea

Monitor for additional symptoms

You may experience other symptoms after surgery. If you are concerned or unsure, inform your healthcare provider. These include:

• Persistent or intermittent fevers, > 101 F
• Recurrent nausea or vomiting with the inability to tolerate anything orally
• Worsening severe pain that is refractory to normal pain medications
• Bleeding > 1-2 pads per hour or any dizziness
• Redness and/or discharge at the incision sites
• Abnormal vaginal discharge

Depending on the surgery, your doctor may recommend other signs to watch out for

Eat a light but nutritious diet

We recommend a light but nutritious diet immediately following surgery. Foods like smoothies, protein shakes, broths, and liquid diets are easier to digest. It is important to stay adequately hydrated during this time. Initially, you should avoid foods that are more difficult to digest e.g. high fiber foods or foods that create a lot of gas.

Anesthesia and certain pain medications after surgery cause constipation. You should not expect a bowel movement immediately after surgery. Laxatives, suppositories, and enemas are generally avoided in this setting as your bowel function will naturally return. Your doctor may recommend a mild stool softener. You should be able to return to a normal diet after the first few days post-surgery or after regular bowel movements return.

Long term, your doctor may also recommend switching to an anti-inflammatory diet to minimize potential symptom flareups.

Incision care

Most surgical stitches dissolve on their own within 2-6 weeks and there is no need to remove them manually. Your physician will tell you if there is required stitch removal in the office.

Ensure that the areas around the stitches are free from irritation due to clothing or any other material. You can shower but should avoid soaking the incision areas for 4-6 weeks. Be gentle while showering and afterward, keep the area dry and clean. This will reduce the risk of infection.

The incisions are usually covered with steri-strips, which will be taken off in the office at your first visit and only reapplied as necessary.

Postoperative management

To fully maximize the benefits of excision surgery, we recommend consideration of complementary therapies, medical management, fertility preservation, or pregnancy.

One of the main advantages of laparoscopic deep excision surgery is an increase in spontaneous fertility. We do not advocate procedures that lead to surgical infertility such as hysterectomy or oophorectomy unless there is an absolute need if that is the patient’s choice.

For those who are currently or no longer interested in pregnancy, a low-dose oral contraceptive or an intrauterine contraceptive device may be prescribed. Other medical management options are available and your physician will discuss them with you if appropriate.

Allow for emotional recovery

Typically, laparoscopic excision of endometriosis will result in a reduction of pain and provide a sense of relief and validation. At the same time, pain, restricted activities, and increased irritability following the procedure can also take an emotional toll.

Utilize the suggested recovery time for both physical and emotional rest. Minimize exposure to negativity and look for ways of calming your body and mind via techniques such as yoga and meditation.

The surgeons at the Seckin Endometriosis Center (SEC) recognize that surgery is the first step in your road to recovery and that this condition often requires continued specialized care.

Have you had a laparoscopy to treat your endometriosis? Please do not hesitate to share your experience and any postoperative care tips on our post on Facebook or Instagram