Activity after open or laparoscopic abdominal surgery

Activity after open or laparoscopic abdominal surgery

By Matthew Johnston, MD
General Surgeon

Every patient who visits my office with a surgical condition has several decisions to make and has a lot of information to absorb and understand.

I typically spend much of our time together describing the condition itself, why I recommend surgery, how I will perform the surgery and any risks involved in the procedure. While this is all critical to anyone’s understanding of their treatment plan, once the decision has been made to proceed with surgery, many patients’ concerns quickly turn to their recovery and what to expect after surgery. Most patients want to know when they can get back to walking, lifting, exercising, and their normal daily routine. While every patient and procedure is different, some generalizations can be made to help you know what to expect.

General abdominal surgery can broadly be separated into two categories: 1) open surgery where a large incision is made through the abdominal wall and 2) laparoscopic (or robotic) surgery where the procedure is preformed through multiple small incisions. Both types of surgery are used for a wide array of surgical problems.

The recovery from these two types can be different. Every patient should ask their surgeon wound care questions, dietary restrictions or signs of possible complications specifically related to their recommended procedure. There will be activity restrictions in the early postoperative period for all surgical procedures.

Many people wonder why we limit activity after abdominal surgery. One simple answer is that significant exertion of the core muscles of the abdomen will cause pain early after surgery. Secondly, whether open surgery or laparoscopic surgery, every surgeon needs to close the innermost musculofascial layer of the abdominal wall with suture at the end of the operation. We limit everyone’s activity after surgery so that this closure can heal. If the area is not allowed to heal then an abdominal hernia can develop which may require more surgery in the future to repair.

If you are having a laparoscopic surgery, the size of the incision is small and will heal quickly. I usually restrict my patients to no lifting over 20 pounds for two to three weeks, depending on the surgery. I recommend avoiding any activity that causes straining, such as pushing, pulling and jumping. Avoid straining with bowel movements by eating a high fiber diet or taking stool softeners to avoid constipation. There are usually no further restrictions.

With open surgery, the incision that needs to heal is much larger and similar lifting restrictions are given for at least a month or longer, depending on the surgery. Patients should also realize that they may feel quite run down after surgery as much of their usual excess energy used for activities is diverted to the healing process. This can last for one or two weeks.

I always remind everyone that a little caution and restraint in the first weeks after surgery can prevent significant problems down the road.

Comments
Derek Cockrell
Hi I have just returned home from an open surgery operation - the wound is vertical and approximately 14 cm in length - vertical

I cannot believe I am this week - how long will this take?

I have booked off from work fot 5 weeks - is this normal?

Thanks
Derek
2/25/2014 12:49:43 PM
JB
I had umbilical hernia surgery mid Dec. (12 months ago I had my second c.section, and 10 months ago I had my gallbladder removed) what kind of exercises can I start doing? .....I am VERY afraid the mesh won't hold! ( I am overweight)
2/3/2014 6:19:12 PM
T
Thank you for your response. Your article was very interesting - I wish more doctors were as thorough as you seem to be. Do you put and is it normal for patients to go onto something to assist their bowel movements long term after this sort of surgery?
I have been put on Normicol and advised that I will need to be on this for the rest of my life - I have never had any issues with my bowels, but do seem to struggle now some days.
10/8/2013 12:55:10 AM
Matthew Johnston, MD
Surgeons give recommendations about activity after surgery based on complexity, size of the incision and any concerns regarding infection. The risks for activity too soon after surgery primarily is developing a hernia; not knowing any of these specific issues in your case I recommend you speak to your surgeon about why they gave you this recommendation and discuss your individual risks directly.
10/4/2013 12:17:20 PM
T
I had open surgery 6 weeks ago to remove my appendix and have been advised that I must not run until mid November. Why would you think it isnt advisable to run sooner. What are the risks to running before mid November?
I'm feeling very frustrated at not beiing able to exercise :(
10/4/2013 5:13:51 AM
Christopher Lewis
Excellent article from the surgeon who saved my life :)
8/23/2013 1:55:26 PM
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