Abdominal Pain from Laparoscopic Surgery

One of the most uncomfortable aspects after having Laparoscopic Surgery, is the subsequent organ, diaphragm & possible shoulder pain. This is caused by the CO2 gas becoming trapped against the diaphragm.

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Yes, it's true, these types of surgeries require the use of CO2 to fill the area having surgical repair. Uncomfortable as it is, rest assured that as the gas passes through, you will feel relief from the pain. Walking, massage, cold/heat compress, and analgesics often bring the quickest relief.

The most important thing you can do after surgery is to walk with the AbdoMend™ belly band securely around your tummy to make it easier to move. Walk early and walk often. There are many benefits to walking after surgery, such as preventing blood clots and intestinal stoppages. Walking encourages the peristaltic movement of the bowels, relieving gas and constipation, we also suggest massage for your legs. Other types of movement include pointing and flexing the toes and feet, and if you can, pulling the legs up to the chest and releasing them.

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There are two common types of gas pain that may occur after surgery. They are quite different, but can both provide discomfort. The frequency of questions about both types, show that many people suffer from – and seek relief from – postoperative gas pain. We will refer to the two types as intestinal and intraperitoneal gas pains. Intestinal gas pains are caused by a buildup of gas inside of the intestines.

GASTROINTESTINAL GAS PAINS

This type of pain can occur after any type of surgery, but is most common after abdominal and pelvic surgery. Both open surgery with longer incisions and laparoscopic surgery in the abdominal cavity can leave the bowels (intestines) ‘stunned’. Anesthesia (general, as well as epidural and spinal) can slow down the bowels, preventing the passage of gas and stool.

INTRAPERITONEAL GAS PAIN RELIEF

Intraperitoneal gas pains are caused by gas trapped outside of the intestines, but inside the abdominal cavity. The gas that becomes trapped in abdominal cavity,or against the diaphragm muscle itself, has an entirely different mechanism of causing pain. This type of gas pain usually follows laparoscopic surgery.

The laparoscopic technique of minimally invasive surgery uses smaller incisions and has a shorter recovery time with less overall pain. Heating pads may also provide relief, but can increase swelling and should not be applied to bare skin due to numbness. If you are allowed to drink, hot tea is a great remedy to help gastrointestinal motility and relieve painful gas pains. Bring some "smoothe move" tea into the hospital in your bag.

Medications, such as simethicone or Colace, allow gas bubbles to be eliminated from the body more easily, and are often used to help with gas passage. Gentle massage around the abdomen to remind body all is well, can help reduce the shock to the body.

How does the gas get into the abdomen?

When laparoscopic surgery is performed, a small incision is first made to pass a special needle into the space of the abdominal cavity, staying outside of the organs. Through this long, thin Veress needle, gas (usually carbon dioxide) is passed. This inflates the abdomen and causes the abdominal wall to form a dome over the organs. This gas dome is maintained throughout the laparoscopic surgery.

Other small incisions are made to pass the small instruments to perform the surgery. Having the abdominal cavity inflated and the abdominal wall separated from the organs, gives the surgeon room to operate with their special instruments without making large incisions.

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At the end of the operation, the abdomen is allowed (and sometimes assisted) to deflate. The carbon dioxide –CO2—is released from the abdomen. More than likely, they are not able to remove all the CO2. The little bit that is left behind can irritate the peritoneum – the lining over the abdominal organs and sometimes the organs themselves. This can be felt as sharp or achy pains. In addition, the CO2 can settle up under the breathing muscle called the diaphragm.

Because of how the nerves connect, or the vagus nerve - this irritation is felt as pain in the lower chest and at times, up into the shoulder area. This type of pain can be quite uncomfortable and may last several days. It will eventually resolve on its own, but can be aided by walking and moving around. In this case, pain medications may be helpful and will not make this type of gas pain worse, since pain medications tend to decrease activity in the intestines, we suggest soupy foods and papaya enzymes, combined with colic.

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