Abdominal Surgery / Laparotomy

• General. Take it easy the first week after surgery but resume daily activities. Gradually increase your activity as tolerated.
• Stairs. Apprehension about stairs or weakness in mobility requires help when climbing up and down stairs. You are allowed to use the stairs if you feel able.
• Lifting. Avoid heavy lifting (nothing over 10 pounds) for the first 6 weeks. Then lift as you feel comfortable.
• Exercise. Use common sense when starting an exercise routine after surgery. Start out slowly and gradually increase time, distance and speed.
• Driving. Driving can begin only after you have stopped taking narcotics, and if you feel strong enough to be able to stop the vehicle in an emergency. If you are not confident, have someone drive you.

Intercourse should be avoided for 6 weeks if a hysterectomy was done. Otherwise, avoid intercourse for 4 weeks or until you feel comfortable.

You may take a shower the day after surgery. Tub baths should be avoided until your incisions are healed.

Just keep your incisions clean and dry. No special creams or ointments are needed. If you have staples they should be removed 7-10 days after surgery. Please call the office to schedule their removal. A small amount of bleeding at the incision sites is not uncommon. If it persists, if you notice a foul smell, increasing redness or pain, call your doctor.

• Incision. Pain around the incision sites is not uncommon, and will resolve over several days. Most patients describe pain as minimal or moderate, and will improve daily.
• Pelvic and Rectal. Some patients describe pressure and pain with urination or with bowel movements. These symptoms resolve and are due to irritation to the rectum and bladder from the surgical procedure, and will resolve with time.
• Sore Throat. Some patients will have a sore throat from the tube that is placed during anesthesia. Throat lozenges, warm tea will help soothe the discomfort and this will resolve within a few days.
• General. Pain should resolve over time, and will get better every day. If pain persists or becomes worse, a visit to the ER at the hospital where the procedure was performed is recommended.

You will be given a prescription for Motrin prior to surgery (start Motrin after surgery) and a narcotic (Percocet, Tylenol 3, or Vicodin) at the hospital prior to your discharge. To be effective Motrin should be used in doses of 600 mg every 6 hours, or 800 mg every 8 hours. Narcotics should be used sparingly since they will cause constipation. The first several days following surgery, most patients use mainly Motrin or extra strength Tylenol during the day, with use of a narcotic sometimes at night to help with sleep. Using a heating pad on the lower abdomen is safe. Coughing can be uncomfortable initially because of abdominal discomfort. Placing a pillow on the abdomen to support your abdomen while coughing can be helpful.

• Abdominal. Some degree of abdominal distension (swelling) is to be expected after surgery. This is due to distension of the intestines, and resolves over time. It is usually mild to moderate only.
• Extremities. Swelling of the legs and sometimes arms is not uncommon after surgery. This is due to increased fluid given during the procedure. This will resolve over several days. If you notice persistent or increasing swelling, tenderness to the calf or calf pain, please call the office immediately.

Constipation can cause severe pain that can get worse with increased amounts of medication. If you experience constipation, drink lots of fluid and eat a high fiber diet. You may also use a mild laxative, such as Milk of Magnesia, or a stool softener, such as Colace. No prescription is required for either.

Diarrhea sometimes is cause by antibiotics and will resolve once the antibiotics are stopped. A pro-biotic such as lactobacillus can help with this process. Rarely, severe diarrhea can develop. Call your doctor if you have severe diarrhea, bloody diarrhea, or if your diarrhea is accompanied by fever or worsening pain.

Anesthesia is the main cause for nausea immediately after surgery. After the first 24 hours, nausea is more likely caused by either your narcotic pain medication or your antibiotics. If you are experiencing severe nausea, please call your doctor.

Urinary retention is the inability to pass urine through the bladder. A very small number of patients will develop this problem due to the anesthetic used for the surgery. Most patients will have their bladder catheter removed immediately after the surgery. If you are sent home and are not able to pass urine, please go to a local emergency room. A catheter will be placed to allow the bladder to “rest” after the surgery, and will be removed several days later in the office. It is important to have this catheter placed to avoid injury to the bladder.