Providing Fast and Safe Recovery After Surgery
The Enhanced Recovery After Surgery (ERAS) approach to surgery at AdventHealth requires you to play an important and active role in your healing process. Patients who actively participate in ERAS, a comprehensive surgery-recovery program, usually leave the hospital sooner, recover more quickly and experience a reduction in the side effects of surgery. With this program, your healthcare team works with you to ensure:
- Adequate rest through optimal pain control
- Good nutrition by eating and drinking soon after surgery
- Increased activity by getting out of bed soon after surgery
Our goal is for you to have a positive experience and that starts with knowing what to expect. We help you heal by returning your body to normal function as soon as possible after surgery.
The ERAS program consists of 4 steps:
- Preparing for surgery
- Day-of-surgery steps
- Post-surgical hospital recovery
- Healing after you leave the hospital
Your Health Care Team
Your surgeon — working with a team of specialists in different disciplines — will help you recover. They’ll work together to assess your condition and plan the best steps to return your body to its normal function. Your team may include specialists in:
- Anesthesiology
- Diet and nutrition
- Nursing
- Pain management
- Physical therapy
- Respiratory therapy
- Surgery
Together, these specialists will assist you in the care necessary for a fast and full recovery.
How Minimally Invasive Surgery Works
No matter the procedure, most minimally invasive operations for digestive conditions involve one to five small keyhole incisions made in the abdomen. One of these is almost always in the belly button. Your abdomen will need to be inflated with carbon dioxide to provide space for the surgeon to move the surgical instruments. Because of these things, almost every patient who has a minimally invasive surgery will experience:
- Discomfort at the belly button and any other surgical incisions for 1 to 7 days after surgery. Your surgeon will use your belly button to access the surgical site with very small instruments and a scope. You may or may not have had other external surgical incisions. Some level of discomfort at these incisions is normal. If, however, you notice that the belly button or other incision is red, hot to the touch, oozing discharge and/or painful, and/or if you have a fever, please call your surgeon or come to the emergency room.
- Shoulder pain that lasts 1 to 3 days after surgery. The pain is related to the carbon dioxide used to inflate your abdomen. While safe, this carbon dioxide can irritate the diaphragm, or the muscle that separates the abdomen from the chest. When the diaphragm is irritated, it is often experienced as referred pain in the shoulders. The shoulders are not injured. The more active you are after surgery by walking and staying out of bed, the faster this pain will go away.
- Nausea and/or vomiting may occur during the 1 to 2 days following surgery. This is usually caused by the general anesthesia used during your operation.
- Tiredness or fatigue. After having an operation, you will need some time to take it easy. It’s expected that you will need to rest more often and get more sleep during the days following recovery.
Other things to expect after an operation depend on the specific procedure you have. Here are some common surgeries performed at DHI along with what many patients report experiencing after those procedures. Each patient’s recovery may be slightly different, and some may not experience any of these while others might experience many of them.
What to Expect After Surgery
- Achalasia - Heller Myotomy
-
- Discomfort below the sternum for 1 to 7 days following surgery. This is the location of the operation inside your abdomen and chest. It is normal to feel discomfort there for several days.
- Difficulty swallowing solid food for 1 to 5 days after surgery. After surgery you may experience swelling at the end of your esophagus beginning of your stomach, where the muscle of the sphincter was divided. This swelling is normal. Your care team will instruct you on how to eat a thick liquid diet (e.g., dairy-based liquids, yogurt, etc.) for the first two weeks. After two weeks, you can slowly start eating more solid foods until you advance to a regular diet.
- Esophageal Cancer - Esophagectomy
-
- Hoarseness and/or sore throat.
- Inability to sing, hum, or make high pitched sounds.
- A need to be on a clear liquid diet that will slowly progress to a normal diet as you can tolerate more and more solid foods.
- Feeling full quickly when eating (early satiety).
- Diarrhea. The reconstruction of your GI tract may cause rapid transit of your food.
- Bloating. If your cancer was caused by acid reflux, you may have a learned behavior of swallowing air (aerophagia), which puts excess air in the abdomen. After your surgery, your brain will relearn not to do this, and bloating will decrease.
- Having a drain in the neck or abdomen to prevent fluid from building up under your skin. Most patients will have their drains removed either prior to hospital discharge or at their first postoperative visit.
- Gastroesophageal Reflux Disease (GERD) – Fundoplication
-
- Discomfort below the sternum for 1 to 7 days following surgery. This is the location of the operation inside your abdomen and chest. It is normal to feel discomfort there for several days.
- Difficulty swallowing solid food for 1 to 5 days after surgery. After surgery you may experience swelling at the end of your esophagus beginning of your stomach, where the wrap (fundoplication) was constructed. This swelling is normal. Your care team will instruct you on how to eat a thick liquid diet (e.g., dairy-based liquids, yogurt, etc.) for the first two weeks. After two weeks, you can slowly start eating more solid foods until you advance to a regular diet.
- Feeling full quickly when eating (early satiety) for 5 to 7 days after surgery. You will feel full with half or less amount of food you usually eat. This occurs because the surgeon used part of your stomach to construct the wrap (fundoplication), which makes the rest of your stomach smaller. However, as you gradually increase the amount of food you eat, your stomach will stretch back to its usual size.
- Passing more gas. Over time, patients who have acid reflux learn that swallowing air (a condition called aerophagia) pushes acid back into the stomach and relieves some of the heartburn symptoms. Once a normal valve is constructed, the brain has to unlearn this behavior. This can take several months after surgery. During this time, you might notice that you are passing more gas after surgery.
- Increased diarrhea for 1 to 2 weeks. Some patients complain about diarrhea after surgery. This is also caused by aerophagia.
- Gallbladder – Cholecystectomy
-
- Discomfort in the upper right quadrant of your abdomen for 1 to 7 days. This is the location of the actual operation. It is normal to feel discomfort there for several days.
- Liver – Minimally Invasive Liver Resection
-
- Abdominal pain. This is the location of the actual operation and therefore it is normal to feel discomfort there for several days.
- Having a drain in the abdomen. As your body adjusts to the changes your operation made, you will experience inflammation. A drain will be placed so fluids produced by this inflammation can exit your body. Once these fluids decrease, the drain will be removed.
- Nausea, gas, constipation and/or diarrhea. You will be encouraged to drink plenty of water and walk around as much as possible to avoid constipation, which can result from pain medications. Avoiding too much time spent in bed will also help speed your recovery.
- Feeling full quickly when eating (early satiety). You will not be able to eat for the first day or two after surgery. You will start with a clear liquid diet and then progress to a thick liquid diet (e.g., dairy-based liquids, yogurt, etc.). You can slowly start eating more solid foods until you advance to a regular diet.
- Pancreas – Distal Pancreatectomy or Whipple Procedure
-
- Abdominal pain. This is the location of the actual operation and therefore it is normal to feel discomfort there for several days.
- Having a drain in the abdomen. As your body adjusts to the changes your operation made, you will experience inflammation. A drain will be placed so fluids produced by this inflammation can exit your body. Once these fluids decrease, the drain will be removed.
- Loss of appetite.
- Diarrhea. Your remaining pancreas may be having difficulty adjusting for appropriate digestion. If this occurs, please contact your surgeon.
Surgical Consultations For Digestive Cancer Without the Wait
Appointments Within Seven Days for Patients with Cancer
At AdventHealth Digestive Health Institute, we know that after being diagnosed with cancer, patients want and often need to begin treatment quickly. So we make it a priority to offer appointments for cancer surgery consultations within five business days, and often earlier.
Patients who are newly diagnosed with cancer, or have just found out they have cancer again, qualify for this priority access. Our surgeons will make themselves available to see you right away, even for a second opinion. We want to help you start your treatment as soon as possible.
Meet Your Dedicated Experts
Our specialists are passionate about providing collaborative care that addresses your unique needs and goals while ensuring you feel informed and supported every step of the way. Learn more about our team and their areas of expertise.
Let Us Help You Feel Whole Again
Whether you’re experiencing new symptoms or want a second opinion on a diagnosis, our dedicated digestive health experts are here to help you find answers and a path forward. Request an appointment today to take charge of your health and get the personal support you need.