Post-Laparoscopic Surgery: Complications and Care

Q: Post-Laparoscopic Surgery: Complications and Care

Hello： Although laparoscopic surgery results in smaller incisions, the likelihood of wound infection or poor healing varies depending on the specific procedure. <br>The situation you described, where the wound produces discharge a few days post-surgery and shows signs of poor hea

Postoperative condition after laparoscopic surgery?

Hello, doctor.
I underwent laparoscopic surgery on the 22nd, which involved three incisions, with the one at the navel being larger and having a drainage tube.
On the first day after the surgery, there was slight bleeding from the drainage tube during the dressing change, but subsequent changes showed no discharge of any foreign material.
I was discharged on the 25th and managed my own dressing changes at home for two to three days.
I noticed a firm protrusion around the navel that was painful when pressed.
During my follow-up appointment on the 2nd of the following month, the doctor applied pressure around the navel and indicated that this phenomenon is normal, possibly due to fluid that would be absorbed by the body.
If there was inflammation, I would need to return for another visit to have a small incision made to drain it.

The day after the stitches were removed, around six or seven in the evening, while resting in bed, I suddenly noticed discharge from the navel.
Upon inspection, I realized it was blood-tinged fluid.
I immediately went to the emergency room, where blood tests showed a white blood cell count of about 13,000, with no fever.
The nurse continued to express the fluid, and I was sent home for observation with a prescription for oral antibiotics.

On the morning of the 4th, I changed the dressing myself and found that no more fluid could be expressed.
I am unsure if the wound is scabbing or if there is another issue, but there is slight pain when pressing around the area.
I would like to ask the doctor if the above situation is normal.
Why did a significant amount of fluid discharge occur so many days later? I have seen many people who underwent laparoscopic surgery without needing stitches.
How does the doctor determine the surgical approach? What should I do for care now? I initially thought this was a simple procedure, but there have been many complications afterward.

Jessie, 20~29 year old female. Ask Date: 2017/03/04

Dr. Xu Kaixi reply Surgery

Hello: Although laparoscopic surgery results in smaller incisions, the likelihood of wound infection or poor healing varies depending on the specific procedure.
The situation you described, where the wound produces discharge a few days post-surgery and shows signs of poor healing, is not uncommon.
As long as you follow your physician's current instructions for wound care, you should be able to recover smoothly.
The sutures used for the surgical wound are determined by the surgeon's professional judgment based on the specific procedure and the patient's condition, and are not fixed.

Reply Date: 2017/03/04

More Info

Post-laparoscopic surgery recovery can sometimes present unexpected complications, and it's essential to understand what is considered normal and when to seek further medical attention. Based on your description, it seems you have experienced a few common postoperative issues, but let's break down your concerns for clarity.

1. Postoperative Pain and Swelling: It's not unusual to experience some pain and swelling around the incision sites after laparoscopic surgery. The presence of a firm area around your navel, especially if it is tender to the touch, could indicate localized swelling or fluid accumulation, which is often referred to as a seroma. This can happen when fluid collects in the tissue around the surgical site, and it may take time for your body to reabsorb it. Your doctor’s assessment that this is normal and that it may resolve on its own is consistent with typical postoperative care.

2. Drainage and Fluid Accumulation: The fact that you had a drainage tube initially is a common practice to prevent fluid buildup. The drainage of blood-tinged fluid post-surgery can occur, especially if there was bleeding during the procedure. The sudden increase in drainage you experienced, particularly after a few days, can be concerning but is not unheard of. It’s crucial to monitor for signs of infection, such as increased redness, warmth, or fever, which you did by visiting the emergency room. The white blood cell count of 13,000 suggests some level of inflammation, but without fever, it may not indicate a severe infection.

3. Surgical Techniques and Decisions: Regarding your question about why some patients do not require stitches, it often depends on the surgical technique used and the surgeon's preference. Some laparoscopic procedures utilize absorbable sutures or adhesive strips that do not require removal. The decision on which method to use can depend on various factors, including the complexity of the surgery, the surgeon's experience, and the specific circumstances of the patient's health.

4. Postoperative Care: After surgery, it is essential to follow your surgeon's postoperative care instructions closely. This includes keeping the incision sites clean and dry, monitoring for any signs of infection, and managing pain as directed. If you notice any unusual changes, such as increased drainage, persistent pain, or fever, you should contact your healthcare provider immediately.

5. When to Seek Help: If you continue to experience pain, especially if it worsens, or if you notice any new symptoms such as fever, chills, or increased swelling, it is crucial to follow up with your surgeon. They may want to evaluate you further to rule out complications such as infection or hematoma (a localized collection of blood outside of blood vessels).

In summary, while some postoperative symptoms can be concerning, many are within the realm of normal recovery. However, your vigilance in monitoring your symptoms and seeking medical advice when needed is commendable. Always trust your instincts; if something feels off, it’s better to err on the side of caution and consult your healthcare provider. Recovery from surgery can be unpredictable, but with proper care and attention, most patients do well in the long run.

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