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Laparoscopic fundoplication surgery is the gold standard treatment for Hiatus hernia and GERD. All those patients who have undergone laparoscopic fundoplication surgery for acid reflux, or are planning to undergo this surgery, frequently have some concerns regarding the recovery from surgery. They also are eager to know about the activity and exercise restrictions after this surgery.
This surgery is performed by a laparoscopic method and post-surgery pain is negligible. All our patients are out of bed in a few hours of surgery. Most of our patients do not need any injectable medications (including painkillers) after surgery. Oral tablets are started few hours after surgery, once they are allowed to start liquids orally. Even soft diet is soon started on the same day.
Even though there is some pain and they would need pain medications, there are no restrictions on walking, moving around, or climbing stairs from the day of surgery itself. Rather, we encourage our patients to move around more, as this will hasten the recovery. Almost all our patients are discharged from hospital on the next day of surgery. And all of them are quiet comfortable, pain free, moving around on their own, having soft food at the time of discharge. Walking, climbing stairs, and traveling within the city by car, auto or bus can be safely done on the next day of surgery with due precautions.
Once they are back at home, all other routine day-to-day household and office activities can be resumed with a few days to a weeks time as one feels comfortable. Out-of-city travel by car, bus, train, or flight can be done after a couple of days with due precaution and permission from your surgeon.
As in this surgery, the hiatus muscles are repaired with stitches, i;e hiatus hernia is repaired, it is important that excessive pressure and strain in that area of diaphragm muscle is avoided for the initial few months. The complete healing and strength building of the hiatus muscles at the site of stitches after the surgery takes a few months and we should avoid certain activities till then.
All activities and exercises that increase the pressure in your tummy and put a strain on your diaphragm muscle need to be avoided for 3 months after surgery. Thus, rigorous exercise, heavy weight lifting, muscle building, and toning exercises, and different yoga asana and mudra should not be done for the first 3 months. Even Suryanamaskar should be avoided for initial 3 months. Lifting heavyweight, more than 5 kgs during day-to-day activity or work should also be avoided. Sleeping on your tummy should also be avoided for the initial few months.
We advise all our patients to do deep breathing exercises or meditation or pranayam after surgery, as it improves the overall recovery. But we instruct them not to do breathing techniques like Kapal Bhati or anulom vilom for the initial few months, as there are sudden forceful and spasmodic movements of the diaphragm in these breathing techniques.
Patients are also advised not to drive a two-wheeler for an initial one month. And to be extremely careful, not meet a road traffic accident, as it can cause problems at the hiatal repair. Care also should be taken to avoid jerks and bumps while traveling in the initial days.
You need not worry too much as these restrictions are temporary, for a few months only. After 3 months with the permission of your surgeon, you can resume these activities in a gradual manner. There are no lifetime activity restrictions after this surgery.
Most jobs can be safely resumed within a week to 10 days’ time. Those who have complete desk or office work, less travel to go to work can even resume work in a couple of days after surgery. Those having moderately strenuous activity at work, like prolonged standing or operating machines, or who need significant travel for work, can resume work after a week of surgery. Those having more strenuous jobs like working in farms or carpentry or need to lift the weight as part of their job would need to delay these activities for 3 months after surgery. They may choose to resume work early by starting less strenuous work for an initial couple of months. And then after 3 months increase the severity of their work.
You can start driving a car 1-2 weeks after surgery as long as you are comfortable. Though, you should make sure you are driving safely, avoiding even minor accidents and jerks. Having said that, it is very necessary to understand that you should drive only if you are absolutely comfortable, and should not lead to an accident due to your pain or discomfort. Very long drive should be avoided as much as possible.
Regarding driving a bike, more caution is needed. After hiatus hernia surgery patients should avoid driving a motorcycle for about a month. Although, traveling as a co-passenger with someone driving a motorbike can be done with due care. After a month patients can start driving a motorcycle. But even then we advise to restrict the driving of a two wheeler to minimum required upto 3 months post surgery. And to be very careful while driving a two wheeler to avoid jerks and accidents.
Traveling in an auto can be done with care to avoid accidents and jerks. Train or bus travels or a car journey can be safely done within a few days. The same applies to a short flight journey. Although we advise that very long travel by road, especially frequent travel continuously for many days like on a vacation should be avoided in the initial months of surgery.
Walking can be done as much as you want within days of surgery. Light jogging, cycling, and swimming can be resumed after a month of surgery. After laparoscopic fundoplication surgery, moderately strenuous exercises like yoga stretches, Surya namaskar, and playing sports can be resumed 3 months after surgery. This is because we would like to avoid strain on the abdominal core muscles during the healing period.
Most of the hernia patients can do rigorous exercise and weight lifting a 5-6 months after surgery. Aggressive contact sports like football, tennis and cricket should also be avoided for initial 3-4 months of surgery. Generally, many patients who have GERD and hiatus hernia problem for many years are less likely to be doing these exercises before surgery. And hence less likely to be concerned about avoiding heavy weight lifting for initial few months after surgery.
But again for this level of activity, it is always better to discuss it with your surgeon. And when you start these sports or exercise after surgery, it should always be done in a slow and gradual manner. Suddenly, starting aggressive exercise after a long period of absence of exercise can lead to various kind of muscle injuries that will hamper your smoothly getting back to these activities.
Hopefully, this addresses your concerns related to activities and exercise after a laparoscopic Nissen fundoplication surgery, that is surgery for acid reflux, GERD, or hiatus hernia. But, you need to understand that, that these are the common blanket advice for all patients undergoing such surgery. And I strongly advise that you should discuss this with your surgeon if any adjustment in the above advice needs to be done, depending on the size of the hiatus hernia, the strength of your muscles, surgical details in your case, and your other medical issues.
Your health journey is personal. Whether you’re dealing with GERD/Acid reflux and/or IBS, the right medical approach can make all the difference. Dr. Chirag’s approach focuses on patient education, precision, and compassionate care.
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ADROIT is one of the few centres for GERD treatment that offers everything required for GERD treatment under one roof. It provides all the evaluation tests including Endoscopy, Esophageal manometry, 24-hour pH with impedance study and where the treatment includes not only surgery but also nutrition and psychological support along with regular follow-up for a long time, resulting in the best long-term results for our patients
Dr. Chirag Thakkar is a gastrointestinal surgeon. He has been carrying out Gastrointestinal and weight loss surgery in Ahmedabad, Gujarat, India for the past 18 years. Surgery for GERD, Hiatus hernia and Obesity are his core areas of interest and expertise. Even in the case of laparoscopic hernia surgery for complex and recurrent hernias, patients recover faster with minimal post-surgery pain and the best functional outcome. He also has vast experience in laparoscopic surgery for gallstone removal.
Dr.Chirag Thakkar
