Post-Operative Wound Issues After Laparoscopic Ovarian Cyst Surgery

Postoperative wound issues after peritonitis surgery?

I underwent laparoscopic removal of an ovarian cyst, but developed a rectal perforation that led to peritonitis, requiring another abdominal surgery.
The incision extends about 14 centimeters from my lower abdomen to my navel.
It has been nearly three months since the surgery, and I still experience occasional pain.
There is swelling and tenderness above the upper abdominal incision, especially after eating, and it feels somewhat hard to the touch.
Is this normal? How long does it typically take for the internal wound to heal completely without pain? Should I schedule a follow-up appointment with the surgeon? Thank you for your time and assistance!

Miss Hsu, 50~59 year old female. Ask Date: 2022/11/30

Dr. Chen Jiaming reply Surgery

Scar tissue from such a long vertical abdominal wall incision often experiences occasional mild pain within one to two years post-surgery.
It is recommended to use a supportive abdominal binder for the first six months postoperatively to prevent hypertrophy of the scar tissue and reduce discomfort.
Additionally, changes in weather (such as temperature fluctuations, impending rain, or high humidity) can easily trigger a prickling sensation due to superficial nerve sensitivity affected by the surgery.

Reply Date: 2022/11/30

More Info

Post-operative wound issues after laparoscopic ovarian cyst surgery can be a source of concern for many patients, especially when complications arise, such as rectal perforation leading to peritonitis. In your case, the presence of pain and swelling around the surgical site, particularly after eating, can be indicative of several underlying factors that need to be considered.

Firstly, it is not uncommon for patients to experience some degree of discomfort or pain at the surgical site for several weeks or even months following surgery. This is especially true if there were complications during the procedure, such as the rectal perforation you mentioned. The body goes through a healing process that involves inflammation, tissue repair, and remodeling, which can lead to sensations of pain or discomfort. The duration of this healing process can vary significantly from person to person, depending on factors such as the extent of the surgery, individual healing capacity, and any complications that may have occurred.

The fact that you are experiencing swelling and a hard area above the upper abdominal incision, particularly after meals, could suggest a few possibilities. One common issue is the formation of scar tissue or adhesions, which can occur after abdominal surgery. These adhesions can sometimes cause discomfort, especially if they are pulling on surrounding tissues or organs. Additionally, if there is any residual inflammation or fluid accumulation in the area, it could contribute to the sensations you are experiencing.

It is important to monitor your symptoms closely. If the pain worsens, if you develop fever, or if you notice any changes in your bowel habits, it would be prudent to seek medical attention promptly. These could be signs of complications such as infection or further issues related to the surgical site.

Regarding your question about the timeline for complete recovery, it can take several weeks to months for the internal tissues to heal adequately. While superficial wounds may heal relatively quickly, deeper tissues, including muscles and connective tissue, may take longer to return to normal function. Generally, most patients can expect significant improvement within 6 to 12 weeks post-surgery, but complete healing may take longer.

As for whether you need to return to your surgeon, it is advisable to do so if you have ongoing concerns about your symptoms. A follow-up appointment can provide you with peace of mind and allow your surgeon to assess the healing process. They may perform a physical examination and possibly imaging studies, such as an ultrasound or CT scan, to evaluate the surgical site for any complications like abscess formation or significant adhesions.

In conclusion, while some discomfort and swelling can be normal after such a significant surgical procedure, it is essential to remain vigilant about your symptoms. If you have any doubts or if your symptoms persist or worsen, do not hesitate to reach out to your healthcare provider for further evaluation and management. Your health and well-being should always be the priority, and timely medical advice can help ensure a smoother recovery process.

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