Problems After Abdominal Surgery

The type of surgery you have affects what you experience afterwards. The pain you can expect to have, and any complications that might develop, will vary from one type of surgery to the next.

First, there are many different types of abdominal surgeries. A cholecystectomy involves removing the gallbladder. An appendectomy is done to take out the appendix. Bariatric surgery helps obese people lose weight. A bowel resection removes part of the intestine. A splenectomy removes the spleen. There are many other types of abdominal surgeries.

Also, the way the surgery is done can affect your experience after the procedure. Many abdominal surgeries are done by laparoscopic surgery. This means that a surgeon will use very small cuts (incisions) to insert a tiny camera to see inside the body and very small tools to perform the surgery. Traditional surgery usually requires a larger incision. This opens the body to have direct access to the organ or area being operated on. Recovery often is less painful and quicker for laparoscopic procedures.

Make sure you talk with your surgeon about your specific type of surgery, including the method that will be used.

HOME CARE INSTRUCTIONS

Pain Management

Each person's experience of pain after abdominal surgery is different. Some people need only a few doses of pain medication after the surgery. Others need pain medication for a week. It is important to always let your caregivers know if you are in pain. A scale of 0 to10 is usually used to help you explain your pain. A 0 means no pain, and a 10 means the worst pain you can imagine.

  • During surgery, you may be given medication that will help reduce pain after the anesthesia has worn off.

  • Right after surgery, you will still have an IV in your wrist or arm. This may be used to give you some pain medication early in your recovery period.

  • You might have a device that lets you control your own pain medication. It would be attached to your IV. You could press it when you needed pain relief. The device is set by your healthcare team so you cannot take too much medication.

  • Your pain medications might include narcotic or opioid drugs. These are powerful pain relievers. However, they have possible side effects that can include:

  • Lowering your blood pressure.

  • Sleepiness.

  • Itchy skin.

  • Difficulty urinating.

  • Not able to have a bowel movement (constipation). You might need to try a stool softener.

  • Addiction. The chances of this happening are small if you carefully follow the directions for taking the medications.

  • You could be given prescription drugs for pain while you are in the hospital and once you go home. Make sure you understand how much you should take and how often. Do not take more of the painkillers than recommended and also do not take them more often. Do not drive while you are using prescription pain medication and do not operate heavy machinery. These drugs can make you drowsy, dull your senses and slow your reactions.

  • Avoid aspirin and ibuprofen because it can increase bleeding. You should take them only if your surgeon says it is OK.

  • Other things you can do to help minimize pain include:

  • Avoid lifting anything heavy (more than 10 lbs, 4.5 Kg) for 3 to 5 days after laparoscopic surgery and at least 14 days after a traditional abdominal surgery. These times might vary, so ask your healthcare provider what would be best for you.

  • Wear loose clothing. Avoid tight waistbands. Tight-fitting clothes can irritate the surgery site.

  • Take care to prevent infection. Make sure your hands are clean if you need to touch the incision area. Avoid getting the wound wet for at least two days (or until your healthcare provider says it is OK).

  • If you feel a cough coming on, press a pillow firmly against your stomach before coughing. This is called stomach splinting. This can help reduce pain.

RISKS AND COMPLICATIONS

The type of abdominal surgery you have can affect problems that might develop. So can your overall health before the surgery. Ask your surgeon and your other healthcare providers about the specific risks that might apply to you. Those generally associated with abdominal surgery include:

  • Pain.

  • Infection at the surgery site.

  • Numbness at the surgery site.

  • Swelling and bruising.

  • Slow healing.

  • A pooling of blood under the incision (hematoma).

  • Blood clots. Lying still during and after an abdominal operation can cause blood clots to form. This is called deep vein thrombosis (DVT) if a clot forms in a vein deep in the body. These clots usually form in a leg. But, they can occur in other parts of the body, too. The clot can move to your lungs (pulmonary embolism). This makes it hard to breathe and get oxygen into your blood. To keep clots from forming:

  • You will probably be urged to get up and try walking within 24 hours of your surgery.

  • You also may be given a device for your legs that will aid blood flow. This could be a pump that puts a pulse-like pressure on the legs (pneumatic compression device). Or you might need to wear elastic stockings that squeeze the veins (compression stockings).

  • You may be given a drug that thins the blood.

  • Blocked intestines. Swelling around the surgery site can make it hard for the intestines to digest food and move it along. This is usually temporary.

  • Excessive bleeding. This is rare.

  • If you are pregnant, surgery can cause early labor. It also can pose a risk to the fetus. Talk with your surgeon and obstetrician about your personal circumstance.

  • Kidney damage. An infection or other problems can develop. This is rare.

  • Damage to nearby organs. This depends on your particular surgery and the organs that might be involved.

  • Hernia. This is a bulging or weakness of the muscles in the abdomen. This can develop at the surgery site. Or, it can develop elsewhere in the abdomen or groin.

  • Pneumonia. You may be given breathing exercises to do after surgery. The aim is to reduce your chances of developing a lung infection.

  • Heart problems. Abnormal heartbeats can develop. So can a heart attack. Heart problems, though, are rarely caused by abdominal surgery. But, if you have heart problems before abdominal surgery, be sure to discuss your specific situation with your heart doctor and your surgeon.

SEEK MEDICAL CARE IF:

  • You notice blood or fluid leaking from the wound, or it becomes red or swollen.

  • You become nauseous or throw up for more than two days after the surgery.

  • Your pain or fever becomes worse than when you left the hospital.

  • You have difficulty or irritation when urinating.

  • Blood appears in your urine.

  • You are unable to have a bowel movement.

  • Blood appears in your bowel movements.

  • You develop a cough.

  • You develop a fever of more than 100.5° F (38.1° C).

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have chest pain.

  • You have trouble breathing.

  • You feel severe pain.

  • You develop a fever of 102.0° F (38.9° C) or higher.