What To Expect

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.

• Achalasia - What to Expect After a Heller Myotomy
• Esophageal Cancer - What to Expect After an Esophagectomy
• Gastroesophageal Reflux Disease (GERD) - What to Expect After a Fundoplication
• Gallbladder - What to Expect After a Cholecystectomy
• Liver - What to Expect After a Minimally Invasive Liver Resection
• Pancreas - What to Expect After a Distal Pancreatectomy or Whipple Procedure

Achalasia – What to Expect After a 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 – What to Expect After an 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) – What to Expect After a 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 – What to Expect After a 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 – What to Expect After a 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 – What to Expect After a 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.