A Mayo Clinic study suggests that though patients tend to expect to return to normal activities swiftly after laparoscopic ventral hernia repair, the reality is very different. The researchers found that many of those studied were still experiencing pain and fatigue several days later.
People under 60 and women in particular seemed to have more prolonged recoveries.
The findings were being presented at the Society of American Gastrointestinal and Endoscopic Surgeons annual meeting April 2-5 in Salt Lake City.
Physicians may need to work with patients to set more realistic expectations about recovery and help them better cope with pain and fatigue after the procedure, says senior author Juliane Bingener-Casey, M.D., a gastroenterologic surgeon at Mayo Clinic in Rochester, Minn.
"It may be that people expect, when they''ve seen their neighbors after laparoscopic gall bladder surgery and they''re back taking a walk the next day, that they''ll be able to do the same thing with laparoscopic ventral hernia repair," Dr. Bingener-Casey says. "They will probably find out that it takes several days before they start moving the way they usually do."
Laparoscopic ventral hernia repair is an outpatient surgery performed when a gap forms between muscles in the abdomen, allowing organs or other soft tissues to push through that weakened area and potentially causing obstructions and pain. It is one of the more common surgeries in the United States: Roughly 90,000 ventral hernia repairs are performed in the U.S. each year, the researchers note. Anyone can develop a ventral hernia, though people who have had surgery with an incision, have lung disease, are obese or have weakened immune systems are at higher risk, Dr. Bingener-Casey says.
Researchers studied the quality of life reported by 18 patients over their first seven days after surgery, considered the worst part of the recovery period. They found that the mean levels of patient-reported fatigue and pain didn''t recede to their pre-surgery levels until seven days after the procedure. Women and people under 60 tended to report poorer physical well-being in the days after surgery than men and patients over 60.
"It''s worse than expected for the patients probably. So I think it''s important for patients to have a realistic expectation, so they''re not surprised and disappointed," Dr. Bingener-Casey says. "For the surgeons, it''s important to look at what we can do to improve recovery. Is it the pain control, is there other help we can provide to get through the pain or through the fatigue for the time after surgery?"
Further research is planned to determine whether an individualized approach to patient recovery after the surgery helps people get back to normal more quickly.
Dr. Bingener-Casey''s research is supported by National Institutes of Health grant DK93553.
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