Discharge Instructions for Laparoscopic Nissen Fundoplication
Laparoscopic Nissen fundoplication is done to treat gastroesophageal reflux disease (GERD). GERD happens when food or stomach acid backs up (refluxes) from your stomach into your esophagus. This reflux can damage your esophagus. For the procedure, a few small incisions were made in your belly. Working through these incisions, the surgeon wrapped the upper part of your stomach around the esophagus. This creates pressure on the esophagus, helping hold it closed. The pressure helps prevent food and stomach acid from refluxing.
You will likely stay in the hospital for one or more nights. Once you return home, follow the instructions below and any others you are given.
Here are suggestions for what you can and can't do as you recover from surgery:
You will likely want to take it easy for 3 to 5 days. You can go back to your normal daily routine when you are feeling well enough. When you can return to work depends on what type of work you do. Check with your healthcare provider.
Walk as often as you feel able. This will help with your recovery.
Don’t drive while you are still taking opioid pain medicine. Drive when you are sure you can hit the brake pedal without wincing or hesitating.
Continue the coughing and deep breathing exercises that you learned in the hospital.
Bandage and incision care
Your incisions will be covered by plastic bandages or strips of tape:
Do not get the bandage or wound wet for 48 hours or as advised by your healthcare provider.
You can remove plastic bandages in 48 hours or as advised by your healthcare provider. If strips of tape were used to close your incisions, don’t pull them off. Let them fall off on their own.
Once you can get the incision wet, very gently wash your incisions with mild soap and water. Pat them dry. Don’t use oils, powders, or lotions on your incisions.
Take all prescribed medicines as directed:
Until you can swallow easily, take liquid medicines. If you are given pills, crush them and swallow them with liquids. But some pills can't or shouldn't be crushed. Be sure to check with your healthcare provider or pharmacist before crushing pills.
If you are given pain medicine, take it on time as directed. Do not wait for pain to be severe before you take it.
If you are prescribed antibiotics to fight or prevent infection, be sure to take all the medicine until it is gone.
If you have been on medicines to prevent reflux, ask your healthcare provider whether you should stop taking them.
Eating and drinking
At first, swallowing will be hard. This will improve as you recover. You may also have belly bloating and pain, as you will not be able to belch for a time after surgery. Follow any guidelines your healthcare provider gives you for what to eat and what to avoid during your recovery:
Follow a liquid diet as instructed. Add solid foods back into your diet as you can tolerate them and as instructed by your healthcare provider.
Avoid drinking iced, hot, or carbonated beverages. This is to help prevent discomfort in your belly. Ask your healthcare provider what foods you can eat and drink right after your surgery.
Take small bites and chew your food well. Be sure to swallow the last bite before taking another. Sip water with your meals to help with swallowing.
Avoid foods that stick together. These include peanut butter, bread products, and dry meats. They can be tough to swallow.
Limit foods that produce gas. These include tomato products, fatty or spicy foods, caffeine, alcohol, onions, green peppers, beans, nuts, and raw fruits and vegetables.
Sit up straight while eating. Stay upright for at least 20 minutes after a meal.
If eating makes you feel bloated, try several small meals a day instead of 3 large meals.
Keep follow-up appointments
Keep your follow-up appointments. These allow your healthcare provider to check your progress and make sure you’re healing well. During office visits, tell your healthcare provider if you have any new symptoms or any reflux. And be sure to ask any questions you have.
When to call your healthcare provider
Call your healthcare provider right away if you have any of the following:
Chest pain or trouble breathing (Call 911)
Reflux symptoms that continue or return
A large amount of abdominal swelling or pain, especially pain after coughing
Belly that becomes tender or feels hard
Increased redness or drainage of the incision
Fever of 100.4°F (38°C) or higher, or as advised by your healthcare provider
Inability to drink or eat
Bowel movements that are black or bloody
Pain or tenderness in your legs
September 02, 2017
Pathophysiology and Treatment of Fever in Adults. UpToDate, Surgical management of gastroesophageal reflux in adults. UpToDate, Treatment of HIV-Infected Adults Who Have Trouble Swallowing Pills: Liquid, Chewable, and Crushable Formulations. UpToDate
Fraser, Marianne, MSN, RN,Lehrer, Jenifer, MD