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Hernia Surgery

Laparoscopic Nissen Fundoplication

Postoperative Instructions for Laparoscopic Nissen Fundoplication

Follow-up

Please contact our office at 216-286-6801 to schedule a follow-up appointment for 10 – 14 days after release from the hospital.

Diet

Repair of your paraesophageal (or hiatal) hernia requires some diet restrictions after surgery. You will need to stay on a liquid/soft diet for approximately three weeks after surgery. During that time, you can try or experiment with eating soft, mushy foods like tuna, mashed potatoes, eggs, cottage cheese, and thick soups. The reason for liquids is that there will be some swelling where your hernia was repaired. You may also notice that swallowing feels a little tight. This will improves as the swelling goes down. With time, you will be able to digest foods normally.

Also, do not drink carbonated beverages for three weeks following surgery.

Some patients find that their appetite is poor or that foods do not taste good after surgery. This is a normal result of the stress of surgery and manipulation inside the belly. Your appetite should return in several weeks. If you do not eat, this is OK; the most important thing is to drink liquids. If you find you are persistently nauseated or unable to take in liquids, contact our office and let us know. Some patients also find that they have diarrhea or loose bowels for the first days after their hernia repair. In the vast majority of cases, the bowel function normalizes with time.

Wound Care

It is OK to shower starting around 36 hours after surgery. If you have little patches of white gauze on the incisions, take off the gauze before showering.

You should see little pieces of tape (called steri-strips) directly attached to your skin. It is OK to get these little tapes wet in the shower. The tapes will begin to peel up on the ends 7 –10 days after surgery — at this point they have done their job and it is OK for you to peel them the rest of the way off if you wish. You do not have to have them on when you come for your postoperative visit.

We try to close your incisions to leave the smallest possible scar. Do not put any ointment or other medication on your incisions: it will not improve or speed up healing.

Medications

You will be given a prescription for an oral pain medicine. This medicine can be constipating and we recommend taking Milk of Magnesia (two tablespoons; twice a day) while taking the pain pills to avoid constipation. You will also receive a prescription for an anti-nausea medicine (usually Phenergan). You should only take this pill if you feel nauseated. It is important to avoid retching and vomiting postoperatively or you could disrupt the repair of your hernia. Unless your surgeon advises you otherwise, you should continue all of your pre-operative medications on the same dose and schedule.

Activity

There are no significant restrictions on activity after surgery, That means it is OK to walk, climb stairs, have sexual intercourse, mow the lawn, or exercise, as long as it does not hurt. In fact, returning to normal activity as soon as possible will most likely enhance your recovery. Try to avoid heavy lifting (greater than 20 – 30 pounds) for several weeks, if possible.

You may also feel easily fatigued for a week or two following the surgery. These factors will put some limitations on your activity, but you will not cause any damage, even if some soreness is experienced.

Everyone returns to work at different times. As a rough guide, most people take at least one to two weeks off prior to returning to work. If you need particular documentation for your job, call the office.

Driving

Assuming the surgery is done laparoscopically, you will usually be released to drive when you have not needed the narcotic (prescription) pain medications for two days.

When to call

Call your surgeon's office if any of the following occur:

  • Fever to 100.4 or greater
  • Shaking chills
  • Pain that increases over time
  • Redness, warmth, or pus draining from incision sites
  • Persistent nausea or inability to take in liquids

Other Issues

The first bowel movement may occur anywhere from one to five days after surgery. As long as you are not nauseated or having abdominal pain, this variation is acceptable. Remember that it is very common to pass a lot more gas from your rectum; this is because you will not be able to really belch.