Minimally Invasive Hiatal Hernia Repair or Anti-Reflux Procedure

 If you need to contact your doctor or nurse before your surgery, please call the thoracic surgery clinic at 303.724.2799.

Here is some helpful information about your stay at our hospital after your procedure.

 

How long will I be in the hospital?

• Patients who have this surgery most often stay 2 to 4 nights in the hospital.
• You will leave the hospital and go home when all these things have happened:

• Your pain is under control.
• You can get up and walk.
• You are eating well.
• Your bladder (urine) and bowel function are normal.

 

Medicines to help control your pain:

• After surgery you will be given different medicines to help with your pain, such as:
• Acetaminophen (Tylenol)
• Ibuprofen (Advil, Motrin) or other anti-inflammatory medicines
• Lidocaine patches 
• You may need to take narcotic pain medicine by mouth or IV (intravenous) after surgery. Your provider will decide if you need to take narcotics based on your pain level. 

 

Activity:

• We will help you walk (with a nurse or other staff) starting the day after surgery. We will help you walk 3 to 5 times a day. This is very important to help prevent problems after surgery such as:
• Pneumonia
• Blood clots
• If needed, you will meet with a physical therapist before you leave the hospital.
• We will give you an incentive spirometer (IS) and instructions on how to use it.
  • Doing small exercises with your IS will help with your breathing.
  • This can also keep you from getting sick after surgery (for example, pneumonia).
  • This is very important to help you have a good recovery.
  • You will be asked to use the IS 10 times every hour when you are awake.

• You will have an alarm on your bed for your safety. We will also keep the side rails on your bed up until the nursing staff says that is safe for you to walk on your own.
• To keep from getting blood clots, you will be given a blood thinner injection (shot) and will use a sequential compression device (SCD):

7. An SCD is a machine that gently squeezes the legs to help with blood flow. 

 

What to know about lines and drains after surgery:

• You may have a drain in your bladder, which is called a urinary catheter. Your doctor will put this drain in if your surgery lasts a long time. The catheter is often taken out in the operating room or the day after surgery. 
• You will have an IV (intravenous catheter) in place while you are in the hospital. This is taken out the day you leave the hospital.

 

Diet:

• You will be on a clear liquid diet the day after surgery. If you are able to have the clear liquids without any problems, you will be changed to a full liquid diet the next day.
• Most often, you will go home on a full liquid diet or soft diet. You will stay on this for about 2 weeks until you come to the clinic for your post-op visit.
• You will need to be in a chair or sitting up in bed at 90 degrees while drinking or eating.
• Anesthesia and pain medicines can sometimes make you feel nauseated after surgery. We will give you medicines to help you feel better while you are in the hospital.

 

Talking to your medical providers:

• Your team of providers will visit you each morning. During this visit they will:
• Check your incisions (surgical cuts).
• Look at your chest tubes.
• Talk about the plan for the day.
• They can also see you at other times if you have any questions or problems.
• A nurse will see you on a set schedule all day and night. You can also ask to see them any time using your call bell. Your nurse will talk with your surgeon and provider team often.

 

Monitoring after surgery:

• After surgery, you will be on a heart monitor (also called telemetry). You will have small leads attached to your chest to monitor your heart.
• We will check your oxygen levels all the time by putting a probe on your finger.
• We will check your vital signs every 4 to 8 hours. We will check your:
• Blood pressure
• Temperature
• Breathing
• Pain control
• You will be given oxygen after your surgery using a small tube that blows oxygen into your nose (a nasal cannula). The amount of oxygen will be lowered slowly while you are in the hospital.
• Because you had lung surgery in Colorado, where the altitude is high, you may need to go home with oxygen.

 

When you leave the hospital (discharge):

• All discharge medicines will be filled at the pharmacy in the Anschutz Atrium. You can pick them up before you leave the hospital.
• If you need to have your prescriptions sent to a different pharmacy, tell your provider and they will take care of this.
• Providers will talk to you about when you might leave the hospital all through your stay.
• Before you leave the hospital, we will set up a follow-up visit with your surgeon.

 

Your case manager:

• You will have a case manager who will work with you during your hospital stay.
• They will help set up any services you may need for extra support at home.

 

 

After Your Minimally Invasive Hiatal Hernia Repair or Anti-Reflux Procedure

Here is some information about what to expect after you go home from the hospital.

 

Follow-up appointments:

• You will have a post-op appointment with your surgeon about 2 weeks after discharge. This appointment will be set up before you leave the hospital.
• You will need a chest X-ray before your appointment. You can go to the radiology department for your chest X-ray 30 minutes before your appointment with the surgeon.

 

Recovery times:

• You should be back to your normal routine and activities (including work or school) by about 2 weeks after surgery.
• Patients often feel fully recovered after about 6 weeks.
• Please remember that each patient’s recovery time is different.

 

How to take care of your incisions (surgical cuts):

• It is OK to shower but do not sit in water (submerge your incisions) for 4 weeks, or until the incisions are fully healed with no scabs. This means no:
• All sutures (stitches) will dissolve on their own.
• Small incisions will be covered with Steri-Strips. Leave them on until they fall off on their own or they are taken off at your post-op visit.
• Bathtubs
• Pools
• Hot tubs
• Lakes
• Oceans
• Do not put any ointment directly on the incisions until they are well-healed (about 2 to 4 weeks).

 

Diet:

• You will go home on either a full liquid or soft diet for 2 weeks. Your surgeon will decide this after your surgery.
• At your post-op appointment, we will talk to you about when you can eat a normal diet.

 

Activity:

• You may do your normal activities if you feel OK when you are doing them.
• No heavy lifting (more than 10 pounds) and strenuous activity for 4 to 6 weeks after surgery.  
• You may start doing light aerobic activity and exercise if you feel OK when you are doing them.
• You should be getting up and walking around many times each day.
• Pay attention to how you are feeling to decide if you should do other activities.

 

Driving:

• You can drive after you stop taking any narcotic pain medicines and you feel better physically.
• This is to make sure your reaction time and strength are back to normal. This usually happens around 2 weeks after surgery.

 

Medicines to help control your pain:

• It is normal to have some pain after surgery.
• You will be given different medicines to help with your pain, such as:
• Acetaminophen (Tylenol)
• Ibuprofen (Advil, Motrin)
• Other anti-inflammatory medicines like naproxen
• Lidoderm patches or lidocaine jelly
• You may also be given a prescription for a narcotic medicine. You can take this as needed for pain that happens in between doses of more mild medicines (called breakthrough pain). 
• You will be asked to slowly stop taking pain medicines at home when you feel better:

• Slowly stop taking the narcotic medicines first.
• Next, stop taking Tylenol or ibuprofen.

 

Other medicines:

You will go home with Senna (a stool softener) to take for constipation. If your constipation does not get better, you can take any of these over-the-counter medicines:

• MiraLAX
• Colace
• A suppository
• An enema

When to call your doctor:

Please call your doctor at 303.724.2799 if you have:

• Fever (above 100.4 F).
• Chills.
• Redness, swelling or drainage at incision sites that is getting worse.
• Shortness of breath that is new.
• Pain that is worse.

 

 

 

 

 

 

 

 

 

 

 

 

©2021, University of Colorado Hospital, Aurora

April 2021

Min inv hiatal hernia anti-reflux proc_Surg