Laparoscopic Appendectomy Post-op Instructions

You have had surgery to remove your appendix, which was done through multiple small holes laparoscopically.

Incisions:
This was done through 3 small incisions that have been closed with absorbable sutures under the skin which you cannot see, and do not have to be removed. There is glue like dressing called Dermabond covering all of the wounds. You may shower the day after surgery, but do not submerge (in a bath, pool or ocean) for 10 days.

Diet:
The expectation is that you will go home the day after surgery, with a few patients requiring a longer stay if the appendicitis was complicated. Your diet will be advanced quickly while in the hospital. After going home, there is not a need for a special diet. There are no foods that are off limits, but I recommend eating lightly for the next 3 days.

Pain:
Pain after this surgery is variable, depending on multiple factors, but probably most related to the amount of inflammation there was due to the appendicitis. Pain is generally felt at the larger umbilical incision (where the appendix was removed) and in the right lower abdomen where the appendix was located. There may be shoulder pain. The shoulder pain is referred pain from irritation of the diaphragm. There is nothing wrong with your shoulders. The pain improves quickly over the first few days after surgery. Pain while in the hospital will be controlled by IV pain medication and then oral medication. When you are discharged, you will be given a prescription for pain medication to use as needed. This is usually Norco (Acetaminophen/Hydrocodone). Use this sparingly, as it can cause constipation.

Activity:
You should be up and around soon after surgery. Hopefully out of bed the same day. When you go home it is important to walk often. You can climb stairs and be active, just avoid any significant lifting (greater than 25 lbs) for 2 weeks.

Medications:
If the appendix was more than a little inflamed I will prescribe antibiotics to take after discharge. These can sometime cause loose stools, or make foods taste different. Please be sure to finish the prescribed course. If you have more significant issues than these, or think you are having an allergic reaction to the medication, call the office.

Issues you may have:
Constipation can occur in the post-operative period, usually due to pain medication use. I recommend using a gentle laxative like Milk of Magnesia.

Nausea can occur, and is commonly related to pain medications. If you are nauseated, Try to hold off on the narcotic pain medication, and take fluids and only small amounts of light foods until it resolves. If the nausea persists anyway, give us a call at the office.
“I am wiped out!” This is common. It will get better.
Call the office if you have Pain that is worsening and/or associated with a fever (temperature equal or greater than 101). It is normal to have some pain, and even a low grade fever can be common. Take the pain medication, or tylenol. Be careful not to combine prescribed pain medication that contains Tylenol (acetaminophen), and OTC Tylenol, or at least be sure not to take more than 4000mg of acetaminophen in a day.