Laparoscopic umbilical hernia repair – surgery, recovery, and your questions answered

Updated Jan 10 2018 – One year on (see end of post)

I’m currently recovering from my laparoscopic umbilical hernia repair surgery. Having never had surgery before, and working closely in the internet search space, I have relied a lot on information found on the web. I thought I’d give back by sharing my own experience, in case it helps others.

How I got the umbilical hernia

After foolishly trying to pull up a rather large shrub root ball–I should have dug it out–I felt a terrible strain in my stomach. Even though I joked that “I need to pop my hernia back in” I didn’t notice I had a hernia until a week or so later. I felt cramped, constipated, and for a while blamed it on shell food the previous night.

I finally realized I had a hernia while doing what us guys do now and then–pick the fuzz from our belly button. After 40+ years of said activity, you get to know the contours of your belly button. Something didn’t feel right.

The diagnosis

My family doctor wasn’t actually sure if I had a hernia or not, so I got a referral from a friend and visited a specialist. He almost missed it too. He finally confirmed a very small umbilical hernia–one that sits just underneath your belly button. We talked about the different options available–open surgery with a small mesh or laparoscopic surgery with a larger mesh. Based on me being overweight but very active (I play a lot of tennis) he recommended that latter. It would allow him to use a larger mesh that would cover enough area to repair the existing hernia, but also prevent the likelihood of it, or another, returning.

Waiting for surgery

It was November and it appears everyone and their mother had decided to get their hernia repaired so they could take advantage of the deductibles they had already paid for the year. That meant the earliest slot for surgery would be January 4th. For the next few days, I would wear a stomach brace whenever I played tennis, but the aching and discomfort from the hernia started to fade. It didn’t get worse and so I stopped taking any precautions. I probably could have gone months, or years, without it getting any bigger, but I decided to stick with surgery to ensure I could have it fixed while still small.

Morning of surgery

My wife and I arrived 2 hours before the surgery time. I was checked in and soon escorted back to a prepping area where a very pleasant nurse helped me get settled. I changed into a robe and socks and then she went through a ton of different questions. They took my blood pressure and it was high. That’s normally the case for me whenever I’m at my doctor’s office, so they were initially not too concerned. I was then shaved from groin to nipples. They used an electric razor and aside from being a little humiliating, was not a big deal.

What happened next was kinda comical. They brought in one nurse to explain her role, then the anesthesiologist to explain what he would do, an EKG to check my heart, inserted an IV for fluids, and then the operating surgeon came to do another evaluation. During all of this, they decided to once again check my blood pressure. Not surprisingly, it was still through the roof. Yeah, no kidding Sherlock! You’re not exactly making it easy for me to relax!

They wheeled me down to the operating room which I remember being a lot smaller than I expected. They draped a very warm–and relaxing–towel around me and placed a mask over my face. They warned me it would smell like beach ball and it did. I drifted off and was blissfully unaware of the next couple of hours.

Waking up

The actual waking up was kinda fuzzy. I don’t remember if they woke me up or if I just came around on my own. I just remember that not too long after first waking up, they moved me up to my recovery room, where my wife was already waiting.

I had practically begged the doctor to let me go home the same day, but he said I may not feel like I would want to. Well, it turns out I didn’t have much choice. The surgery was a little more complicated than expected. My bladder was apparently in a slightly different location and my intestines had started to stick to my stomach fat (which makes me wonder if that would have only gotten worse if I had waited on surgery). The doctor had explained to my wife that intestines don’t like to be handled, so separating them from that fat could be traumatic for them. Hence, I would stay at least one night.

First day after surgery

I was very groggy, but I didn’t have any nausea from the anesthesia. I was able to take sips of liquid and keep them down. My throat was very dry but not too bad sore (from the pipe they shove down your throat to help you breathe). As a side note, I was told there was a 1-4% chance that pipe could chip a tooth. I remember when I woke up I ran my tongue around my teeth to check for any chips–thankfully none.

The nurses were great and checked in on me often. Mostly because they had to prod or poke me for something just about every two hours. This was OK until that night, when I was already having a hard time sleeping on my back (I’m a side sleeper) and they kept waking me up. Here’s what you can expect:

1. Check and change your IV
2. Administer pain meds either by injection to your IV catheter or by adding a hanging bottle.
3. Check your blood pressure.
4. Check your O2 levels.
5. Make sure you’re using the incentive spirometer.
6. Draw blood.

I was on oxygen for the first few hours. Just one of those tubes that sits just under your nose. Once they were happy that my blood oxygen level was normal, they removed that.

My blood pressure was high just about the entire stay. Again, it tends to be high around any “white coat” setting, but when you’re not getting much sleep, getting prodded and poked, and filled with an IV solution that contain a lot of salt and sugar, what do you expect? Any time it exceeded 180/100 they gave me something to bring it back down again.

I had a handful of people stop by to check in on me. I’m not normally one that craves the company of others, but I can’t tell you how much of a blessing it was to see friendly faces. I’m going to make a point of doing the same for my friends in the future.

I was surprised that I was able to get out of bed and even walk a little that first day. However, that first time getting out of bed was a 10/10 on the pain scale. I pretty much cried out like a baby. After that, it got a little easier each time.

Day 2

I didn’t see the doctor again until around 7:30am the following day. I was feeling pretty alert and ready to go home. There was only one problem.

I needed to pass gas.

Now, as my wife can attest, this is normally not an issue at all. In fact, my bowels are stuff of legends! The doctor said that I couldn’t go home until I had passed gas. I later learned from a friend that he had gone home from his surgery without passing gas, and everything ended up backing up so badly, he couldn’t fill his lungs properly and was admitted again. As much as I wanted to go home, I decided not to fake the toots.

The nurses said that walking is one of the best ways to get everything “moving” again. Hearing this, my wife became my personal drill sergeant. She had me up every hour walking the halls of the floor. At one point I took a mid-morning nap for a couple of hours much to her chagrin. 😉 In her updates to friends and family, she actually asked for prayers that I would pass gas. Not something she would normally wish on anyone!

Finally around 4pm I heard the sweet sound of the bottom trumpet! An hour or so later I was discharged and heading home.

Day 3-6

Despite being given a prescription for opioids, I vowed that I would only use that as a last resort. I didn’t even get it filled. Instead, I just alternated doses of Tylenol and Advil and found that they did enough to keep the edge off. The recliner became my best friend. It put me in the most comfortable position. That said, I was still able to sit at my home office desk and do a little work as needed.

The worst pain came whenever I had to cough or sneeze. Again, 10/10 on the pain scale. I learned how to cough more shallowly.

Getting in and out of bed or a chair hurt a little. It felt like a pulling at some internal stitch. The pain only lasted a few seconds each time.

At this point (day 6) I’m still feeling tightness in my stomach. Getting in and out of bed/chair has gotten easier with less pain. I’m just starting to find it tolerable to sleep for an hour or two on my side, but mostly having restless nights sleeping on my back.

Day 8 – Post-op follow up

Just back from a follow up with the doctor. He is pleased with how everything is looking. The pulling pain when I sit down or get into bed is likely from an extra stitch he had to place in that area. He gave me the following instructions:

• Keep the stomach brace on for 6 weeks. Mostly as a reminder to not over do it. I can take it off for sleeping or if I just need a break from it.
• No tennis for 3 more weeks – he doesn’t want me twisting. Not sure how I will survive this. Staying strong!
• No massage or chiropractor for 3 more weeks. I could use one because of my other muscles having to do the work usually done by my core.
• No nookie for one more week.
• If the glue over my stitches starts to peel at the edge, it’s ok to just pull it off.
• The scar around my belly button will get softer over time.

Last night I slept on both sides without any pain. I did feel some tightness, and had to turn over really slow, but got the best night’s sleep since surgery.

I have cut back to virtually no painkillers at this point. Still icing the area once a day.

I am still a little swollen around my stomach–from the surgery, not from the Chick-fil-a. 😉

Day 9 – (Mostly) Pain free

If you’re in the early stages of recovery, you likely feel you’ll never be pain free. I have good news for you. I’m on day 9 and am finally getting to the point where I am pain free. I can get in and out of a chair/bed without any pulling pain–so long as I do so carefully. I’m walking without hunching over and have resumed most normal daily activities.

I still have tightness and some mild aching, but I think I am past the stabbing pains. 🙂

One Year Later

After about 30 days, I was able to do just about whatever I wanted—well, at least the stuff I could do before the surgery. However, I did sometimes get a stitch-like pain in my left side–if I bent over fully–for about 6 months. One year later, the surgical scars are hard to see and the larger incision at my belly button is practically invisible and has softened a lot.

Any downsides? My stomach has not completely flattened out. No one else notices, but if I look down at my belly button, I can see that to the right of it, it’s ever so slightly more extended than the to the left.

Overall, I would do it again, but pray I never have to. 😉

========

Instead of rambling on with random observations, I’ll just switch to an FAQ and hopefully answer the many questions I had and perhaps provide some useful tips.

Questions about laparoscopic umbilical hernia repair surgery

Should I go ahead with surgery if I have a cold?

Absolutely not! Even if they allow it, you do not want to be in recovery while you have a cough or are sneezing. Trust me, that is the worst pain during this experience.

What should I wear the day of surgery?

Wear loose fitting clothing, especially something like jogging pants/shorts. You won’t want any additional pressure on your stomach. Leave all of your jewelry at home.

How big are the holes/scars from the surgery?

I have a number of small incisions around my stomach. More than I expected–6 or so. I am not sure if this is normal or because of the complication encountered. In any event, they appear to be very small and are covered with a waterproof glue. The largest incision is inside my belly button, which I assume is where the mesh was inserted. That is also the only one that is tender to the touch at this point.

Is it normal to swell up?

I was very swollen and bloated for the first few days. The IV will make you retain a lot of fluid all over your body and your stomach will be swollen from the surgery. Once they took the IV out, I would end up urinating every couple of hours to flush out the fluid. By the end of day 3 I was back to normal.

Is it normal for my stomach to look indented/disfigured?

I was shocked at how weird my stomach looked after surgery. It was like a topographical map of a mountain range. Expect some indentions around the laparoscopic incisions. These are just now (day 6) starting to flatten out.

What should I do about the local pain when coughing, sneezing, or getting in and out of bed etc?

The hospital gave me a comfort cushion. It’s a 12×12 cushion that you can use to hold tightly to your stomach whenever you have to do something that involves your core. I love that cushion!

What’s the best way to get in and out of bed after having your hernia repaired?

I am glad that I have an adjustable bed. For the first couple of days, I would raise the head up as high as it would go so that I could more easily get in and out. The best tip for getting out of bed is to swing your legs over to the side, while still laying down, and then do kind of a gymnastic style dismount. This will help you to avoid using your abs to pull yourself up.

Do I need to wear a stomach brace all the time?

Right now, yes. My doctor advised to keep it on until my 1-week follow up appointment at least. It’s actually comforting as you feel like it’s keeping everything in place. I’ve read it also helps to keep any fluids from filling up in the place where the hernia used to be. I take it off only when showering.

Will an ice pack help with the hernia surgery pain?

If you don’t already have those gel ice packs that you get from a chiropractor, get some. They stay cold, but are also pliable enough to conform to your stomach. Ice packs are pretty good at getting you through those times after sneezing or coughing etc.

Any tips for sleeping on my back?

Get a pillow that is shallow enough to sit under your neck without raising your head up too high. Also, get a pillow to place under your knees. If you can, place a pillow either side of your body too–or just tuck yourself in a little. Oh, and bring that small comfort pillow to bed with you in case you have a coughing fit.

Should I take a stool softener?

I had read advice about taking a stool softener the second night after surgery. You certainly will have trouble “pushing” out anything, so that can help–especially if you stay on the opioids. However, after taking it that one time, I didn’t need it again. I actually had no problems, but certainly it took 3-4 days to get back to my normal schedule.

Can I eat what I normally eat after surgery?

I lost my appetite for the first few days. When it did return, I found it easier to eat small meals often. Being bloated and full is not something you want at this time. That said, your doctor will likely keep you on “clear liquids” until you have your first bowel movement. After that, go with foods high in fiber and avoid anything spicy–heartburn would not be pleasant.

What OTC pain medications worked best?

I tried a few different combinations. I read online that taking one 500mg Tylenol and one 200mg Advil had shown the best results in studies. That also allowed me to take something every 4 hours or so.

Please leave any other questions in the comments and I will add them to the list.

I hope this has been useful.

Pass it on...