After hernia repair surgery, the patient is taken to the postanesthesia care unit (PACU). Patients are closely monitored by the nursing staff and remain there until they are stable. The amount of time spent in the PACU depends on the patient's progress and on the type of anesthesia they received. Patients given general anesthesia must be awake and coherent before they leave the PACU.Ice chips are offered to the patient in the PACU, and if those are tolerated, water is given. The intravenous line remains in place until clear liquids can be taken and tolerated. This may occur almost immediately following surgery, especially if a local anesthetic was used. Sometimes general anesthesia can induce nausea, which may delay taking oral fluids. Once clear liquids are tolerated, the diet progresses to solid foods.
Patients are transferred from the PACU to the outpatient or ambulatory unit, where recovery is completed. Inpatients return to their room. Most patients go home once they are up and walking around. Even though the anesthesia has worn off, most patients remain groggy for the rest of the day. Patients must make arrangements for a family member or friend to be with them upon discharge, if they are going home the day of surgery.
Spinal anesthesia usually wears off within a few hours. In the first hour following surgery, patients usually lie flat on their back to decrease the chance of an anesthetic-induced headache, which can be painful and prolonged. A patient must regain full sensation in the region of their body that was numbed before being discharged.
Patients experience pain at the incision site, especially conventional procedure patients. Medication is prescribed and taken as directed. Swelling and discoloration usually develops around the incision and eventually disappears in the healing process. Some soreness can be expected during the first 24 to 48 hours.
Resuming Activity after Hernia Repair
The laparoscopic hernia repair allows patients to return to their normal routine much more quickly. Some people can return to work in just a few days. Recovery from the conventional surgery takes a little longer because there is more pain and soreness around the wound. Generally, a patient can be guided by the amount of discomfort they feel. Any activity, such as driving, that causes pain and puts a strain on the incision should be avoided until it can be comfortably tolerated. The same holds true for work. People with desk jobs usually can return to work within a week or two. People whose jobs require strenuous activity or heavy lifting may need several more weeks of healing before they return to work.
Straining during a bowel movement also puts strain on the incision. It is therefore important that patients eat a high-fiber diet and drink plenty of fluids to avoid constipation. A stool softener may be prescribed by the physician.
Most doctors ask that their patients to return in about a week for a follow-up visit. At this time, all stitches will be removed.
Surgery & Follow-up
Some patients may find that their appetite is poor for a week or two after surgery. This is a normal result of the stress of surgery– your appetite should return in time. If you find you are persistently nauseated or unable to take in liquids, contact our office and let us know.
It is OK to shower starting around 36 hours after surgery. If you have gauze on the incisions, take it off before showering.
You might see little pieces of tape (called steri-strips) directly attached to your skin. It is OK to get these little tapes wet in the shower. The tapes will begin to peel up on the ends 7-10 days after surgery – at this point they have done their job and it is OK for you to peel them the rest of the way off if you wish. You do not have to have them on when you come for your postoperative visit.
No baths, pools or hot tubs for two weeks.
We try to close your incisions to leave the smallest possible scar. Do not put any ointment or other medication on your incisions – it will not make them “heal better.”
There are no medical or physical restrictions on activity after surgery. That means it is OK to walk, climb stairs, lift, have sexual intercourse, mow the lawn, or exercise as long as it doesn’t hurt. In fact, returning to normal activity as soon as possible will most likely enhance your recovery. However, if it doesn’t feel good, don’t do it. Take it easy and let pain be your guide.
Everyone returns to work at different times. If you want, you may return to work right away; however, as a rough guide, most people take at least 1-2 weeks off prior to returning to work. If you need particular documentation for your job, call the office.
You will usually be able to drive when you have not needed the narcotic (prescription) pain medications for two days.
The first bowel movement may occur anywhere from 1-5 days after surgery – as long as you are not nauseated or having abdominal pain this variation is acceptable. Remember that it is very common to pass a lot more gas from your rectum than you used to- this is because you will not be able to really belch. Some patients also find that they have diarrhea or “loose bowels” for the first days after their hernia repair – in the vast majority of cases, the bowel function normalizes with time. Constipation may also be common due to the pain medication. We recommend taking Milk of Magnesia (2 tablespoons; twice a day) while taking the pain pills to avoid constipation.
Pain (male patients only)
It is expected that your scrotum may be slightly swollen or tender. Along with the use of oral pain medications you can use ice packs to help. This is expected and will go away with time.
When to call
Fever to 100.4 or greater
Pain that increases over time
Redness, warmth, or pus draining from incision sites
Persistent nausea or inability to take in liquids