Post-Laparoscopic Surgery Care: Managing Pain and Swelling After Appendectomy

Post-laparoscopic surgery

Hello Doctor, I would like to ask about my condition after undergoing laparoscopic surgery for acute appendicitis two days ago.
I have three incisions, all of which are stitched, and I was discharged today.
I am scheduled to return for suture removal in a week.
However, the incision on my lower left abdomen is red and swollen, and it hurts when touched.
Is it okay to apply ice to it?
Since the surgery, the area around my navel is very swollen, resembling a ball.
I have been getting up to walk and have been able to pass gas, but it still feels like I need to hold my abdomen while walking, similar to being pregnant.
I mentioned this to the doctor, but he did not respond or examine me, only stating that abdominal bloating is normal.
One of my incisions is located 0.1 cm below the navel, and there is a hard area above the navel that is painful when pressed.
On the day of the surgery, I underwent a series of tests, including blood draws from the back of my left hand and a CT scan of the abdomen with contrast.
The most painful moment was when I received the antibiotic injection, as the nurse administered it so quickly that my entire hand went numb and became swollen and painful.
After the surgery, I received IV fluids for about three days.
Today, my left wrist is very sore and swollen.
Should I see another doctor for this, or is there something I can do to resolve it? Thank you for your assistance.

GG, 20~29 year old female. Ask Date: 2018/09/27

Dr. Xu Kaixi reply Surgery

It is normal to experience some pain at the laparoscopic appendectomy incision site for about a week post-surgery.
It is also possible to have abdominal bloating as the gastrointestinal tract has not fully recovered.
The soreness at the injection site on your arm should gradually improve as well.
You may take the oral medications prescribed by your physician to alleviate the symptoms.
I apologize for the delayed response and hope your concerns have improved.

Reply Date: 2018/09/27

More Info

After undergoing laparoscopic appendectomy, it's common to experience some pain and swelling around the surgical sites. The symptoms you're describing, including redness, swelling, and tenderness near the incision sites, particularly in the left lower abdomen, can be typical post-operative reactions. However, it’s essential to monitor these symptoms closely.

Understanding Post-Operative Symptoms
1. Pain and Swelling: After laparoscopic surgery, it's normal to have some degree of pain and swelling. The body responds to surgery with inflammation, which can cause swelling and discomfort. The pain you feel when touching the incision sites is likely due to the healing process, as the nerves in the area are still recovering from the trauma of surgery.

2. Redness and Tenderness: Redness and tenderness around the incision sites can indicate inflammation, which is a normal part of healing. However, if the redness spreads, becomes increasingly painful, or if you notice any discharge from the incision, these could be signs of infection, and you should contact your healthcare provider immediately.

3. Abdominal Distension: The feeling of abdominal swelling, akin to being pregnant, is also common after abdominal surgery. This can be due to gas buildup in the intestines, which is a frequent occurrence after laparoscopic procedures. Walking and moving around can help alleviate this discomfort by promoting gas passage.

Managing Symptoms
1. Ice Therapy: Applying ice packs to the swollen areas can help reduce inflammation and numb the pain. Make sure to wrap the ice pack in a cloth to avoid direct contact with the skin, which can cause frostbite. Apply it for about 15-20 minutes every hour as needed.

2. Pain Management: Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage pain. Always follow the dosage instructions on the label or those provided by your doctor.

3. Activity Level: It's important to balance rest and activity. While it's good to get up and walk to prevent complications like blood clots, avoid strenuous activities or heavy lifting until your doctor gives you the green light.

4. Hydration and Diet: Staying hydrated and consuming a diet rich in fiber can help with any digestive issues that may arise post-surgery, such as constipation or gas.

When to Seek Medical Attention
If you experience any of the following, you should contact your healthcare provider:
- Increased Pain: If the pain worsens or becomes unbearable.

- Signs of Infection: Such as fever, chills, increased redness, swelling, or discharge from the incision sites.

- Persistent Swelling: If the swelling does not improve or worsens over time.

- Unusual Symptoms: Such as nausea, vomiting, or inability to pass gas or stool.

Follow-Up Care
Since you mentioned having a follow-up appointment in a week, it’s crucial to discuss all your symptoms with your doctor during that visit. They can assess your healing process and determine if any further interventions are necessary. If your left hand is still painful and swollen from the IV or blood draw, it may be worth mentioning to your doctor as well, as they can evaluate for any potential complications related to that.

In conclusion, while some discomfort and swelling are expected after laparoscopic appendectomy, staying vigilant about your symptoms and maintaining open communication with your healthcare provider is key to a smooth recovery.

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