Post-Laparoscopic Appendectomy: Pain and Recovery Insights

Laparoscopic appendectomy

Hello, I underwent laparoscopic surgery for appendicitis at the end of February this year.
The doctor mentioned it was a very early stage of appendicitis.
Recently, I've been feeling a sensation in my abdomen that feels like the wound is pulsating.
Is this normal? Is it common to still experience pain after such a long time as the wound heals? (It feels like the pain is coming from inside.) The pain occurs occasionally, and sometimes I feel pain while walking.
Also, could you please tell me if laparoscopic surgery has a risk of internal wound dehiscence or incisional hernia? Thank you.

Niming, 10~19 year old female. Ask Date: 2017/04/11

Dr. Chen Jiaming reply Surgery

In general, laparoscopic appendectomy primarily utilizes the umbilicus as the main incision site for the removal of the excised appendiceal tissue.
The umbilical incision is closed in two layers: the superficial skin and the deeper muscular fascia.
The superficial skin is typically closed with sutures that are removed postoperatively, while the deeper muscular fascia is usually sutured with absorbable materials.
Generally, these absorbable sutures will partially dissolve and disintegrate within about 30 to 60 days post-surgery.
Some patients may experience unusual sensations during this time, which typically resolve within a few days to one or two weeks.
As for the complete healing of the muscular fascia layer, it is generally difficult to assess.
Although there are still cases of incisional hernias occurring at laparoscopic sites, they are relatively rare.
If pain persists for an extended period or if there are symptoms of abnormal bowel obstruction, further medical evaluation is necessary.

Reply Date: 2017/04/11

More Info

After undergoing a laparoscopic appendectomy, it is not uncommon to experience some discomfort and pain during the recovery process. Given that you had your surgery at the end of February and are now experiencing sensations such as a "jumping" feeling in your abdomen, it is important to understand that these sensations can be part of the healing process. The body undergoes various changes as it repairs itself, and nerve endings may still be sensitive during this time.
1. Postoperative Pain: It is normal to experience occasional pain after surgery, especially in the first few weeks. The pain you describe, particularly if it is intermittent and not severe, could be attributed to the healing of the internal tissues and the nerves that were affected during the surgery. The "jumping" sensation could be related to muscle spasms or nerve regeneration. However, if the pain becomes more intense or persistent, it is advisable to consult your healthcare provider.

2. Walking and Pain: Feeling pain while walking is also a common experience post-surgery. As you engage in physical activity, the abdominal muscles and tissues are being used, which can lead to discomfort. It is essential to listen to your body; if the pain is mild and subsides with rest, it is likely part of the healing process. However, if you experience sharp or worsening pain, you should seek medical advice.

3. Risk of Complications: Regarding your concerns about the risk of internal wound dehiscence (the reopening of the surgical wound) or incisional hernias, laparoscopic surgery generally has a lower risk of these complications compared to open surgery due to smaller incisions. However, it is still possible, especially if heavy lifting or strenuous activities are resumed too soon. Most surgeons recommend avoiding heavy lifting (typically anything over 10-15 pounds) for at least 4-6 weeks post-surgery to allow for proper healing.
4. When to Seek Medical Attention: If you notice any signs of infection (such as fever, increased redness, swelling, or discharge from the incision site), or if the pain becomes severe or persistent, it is crucial to return to your healthcare provider for an evaluation. They may perform imaging studies or a physical examination to rule out complications.

5. Recovery Timeline: Recovery from laparoscopic appendectomy varies among individuals. Generally, most people can return to light activities within a week or two, but full recovery may take several weeks. It is essential to follow your surgeon's postoperative instructions regarding activity levels and any restrictions on lifting or exercise.

In summary, while some pain and unusual sensations can be part of the normal healing process after a laparoscopic appendectomy, it is essential to monitor your symptoms closely. If you have any concerns or if your symptoms worsen, do not hesitate to reach out to your healthcare provider for further evaluation and guidance. Your recovery is important, and ensuring you are healing properly will help you return to your normal activities safely.

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