Laparoscopic surgery, often called “keyhole surgery,” is a minimally invasive technique that uses small incisions. It offers advantages such as quicker recovery times and smaller scars compared to traditional open procedures. A common temporary side effect many patients experience is gas pain after the operation. This discomfort is a normal part of the healing process, but can be surprising and often causes concern.
The Cause of Post-Laparoscopy Gas Pain
During laparoscopic procedures, surgeons inflate the abdominal cavity with carbon dioxide (CO2) gas. This creates a working space, lifting the abdominal wall away from internal organs for better visibility and instrument access. CO2 is the preferred gas because it is highly soluble in blood, reducing the risk of gas embolism, and non-flammable, making it safer to use with electrosurgical instruments.
Some CO2 often remains trapped inside the body after surgery. This residual gas can irritate the diaphragm, a muscular sheet separating the chest and abdominal cavities. The phrenic nerve, which runs from the neck to the diaphragm, can become irritated by this retained gas. This irritation is often felt as referred pain in areas like the shoulder, chest, neck, or ribs.
Symptoms and Expected Duration
Gas pain after laparoscopic surgery often presents as bloating, cramping, or sharp, sometimes shooting, pains in the abdomen. This discomfort can also extend to the shoulders, neck, or ribs as referred pain. Some individuals may also experience a heavy feeling in the abdominal area.
The pain may worsen with deep breaths or certain movements. For most patients, this gas pain typically peaks within the first 48 hours following surgery. It gradually subsides over a few days, usually resolving completely within two to three days as the body absorbs the remaining carbon dioxide. In some cases, if gas remains trapped, the discomfort may persist longer.
Effective Strategies for Relief
Managing gas pain involves promoting the absorption and expulsion of residual carbon dioxide. Gentle movement, such as short, frequent walks, encourages the body to absorb CO2 faster and helps gas move through the digestive system. Walk as soon as your medical team approves.
Changing positions can also provide comfort. Lying flat might worsen the pain, so try sitting upright or lying on your side with knees bent. Gentle stretches, like pulling your knees towards your chest, can help shift trapped gas. Applying a warm compress or heating pad to the abdomen or affected shoulder areas can help relax muscles and ease discomfort. Ensure the heat source is warm, not hot, and avoid placing it directly on surgical incisions.
Proper hydration can reduce bloating. Drink plenty of water, and consider warm liquids like peppermint or ginger tea. Avoid carbonated beverages and chew slowly to prevent additional air intake. A temporary diet avoiding gas-producing foods can also be helpful, such as:
- Beans
- Broccoli
- Cabbage
- Certain raw vegetables
Over-the-counter medications like simethicone (e.g., Gas-X) can help break down gas bubbles, reducing bloating and abdominal pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may also be used for pain relief, if approved by your surgeon.
When to Contact Your Doctor
While gas pain is a common and usually temporary side effect after laparoscopic surgery, certain symptoms require medical attention. Contact your doctor if you experience severe or worsening pain that does not improve with self-care or prescribed pain medication.
Signs of infection at the incision sites, such as increased redness, swelling, warmth, or any pus discharge, need prompt evaluation. Difficulty breathing, persistent chest pain unrelated to gas, or a fever higher than 100.4°F (38°C) are concerning symptoms. An inability to pass gas or have a bowel movement for several days, or persistent nausea and vomiting, also warrant a call to your healthcare provider.