Mini-Scar-Less (MSL) Laparoscopic Surgery (LS) has set a new standard in terms of cosmesis and recovery, by far margin, better than the Laparoscopic Surgery
In this article we will list a patient’s expected recovery journey in most cases after standard Laparoscopic Cholecystectomy (LS). There may be variations and one will need to be mindful of variations in recovery and should not hesitate consulting the operating surgeon.
Standard Laparoscopic Cholecystectomy is done with four small incisions in the abdomen under general anaesthetic. This can be done as a day case (a patient going home a few hours after the surgery/ same day discharge) or one-night stay in the hospital.
Surgery typically has an operative time of 15 minutes to half an hour under general anaesthetic. For relatives the overall time seems much longer. Patient’s journey to theatre includes, going down to the receiving are in theatre (5-30 minutes stay), anaesthetic time in theatre (10-30 minutes), Positioning of patient and theatre set up (5-15 minutes in theater), Extubation / bringing the patient out of anaesthesia (5-30 minutes), Observation in recovery area (15-45 minutes).
Overall time spent in theatre complex is 60 – 150 minutes excluding operating time. Once patient returns to the ward, he still remains sleepy / woozy despite being awake and communicable for another hour or two; depending on the type of anaesthesia and pain killers administered during and after surgery.
The other parameters for recovery are as follows:
Generally, 1-2 hours after returning to the ward. One is awake and starts with sips building up to free fluids and diet in a few hours.
Within an hour or two, building up to walking to wash room with supervision and support within four hours. Walks in corridors can be commenced after 6- 8 hours. Sitting on chair outside bed is preferred and recommended.
Passing water/urine commences within a few hours after surgery. One will pass flatus /wind from the day of surgery or one day afterwards. Bowels will generally open day 2-5 after surgery.
On is likely to get constipated because of eating less during this period and getting constipation causing pain killers after surgery. In cases of known history of constipation or not opening bowels after surgery, taking laxatives is advisable. Any laxatives that a patient is familiar with or the surgeon advising, will suffice.
The same day after the surgery or after one-night stay in the hospital. If there were any complications including conversion to an open operation during surgery or any observation of a problem needing addressing, one may need to stay in longer.
There are no restrictions. However, one is advised to slowly build up to normal diet with a day or two after surgery. There is certainly no restriction on fat free diet after gall bladder surgery.
One can travel for reasonable distance by road on the day of surgery or the day afterward. Longer and bumpy journeys can cause discomfort but do not interfere with surgery or its outcome.
From the day after surgery but being sensible and slowing down or stopping if one feels pain or discomfort.
From 4-5 days after surgery onwards, once the patient is off the painkillers.
From 3 weeks onwards, while listening to the body’s recovery and slowing down if uncomfortable, before it becomes painful. Different people will have different recovery times in accordance with their pain thresholds. Be sensible and do not cause yourself pain and discomfort.
Generally, when one is pain free and can focus on driving and road safely with a safe margin. Its variable and can be 4- 7 days after surgery with no complications. Insurance companies may not cover if one drives too early after surgery, while having pain.
In the sea after 1 week
In the pool after 2 weeks
Withing 2-5 days after surgery
“After a day if you are self-employed; after 6 months if you are a civil servant”, is what I told my patients in United Kingdom.
Probably allowing 2 weeks after surgery will suffice in most cases. If in doubt then consult with your doctor.