kseavey

Hey all,

Just wondering - what is the recovery time for a laparoscopic appendectomy? Just had one on Friday - it sucked. Came home from the hospital Saturday at 12 noon (in time for the VT-GT game!).

They were pretty vague as to what I can/cannot do. The most solid thing was "don't lift anything heavy for six weeks," for fear of a hernia. Other than that, there were some conflicting words of advice, ranging from two to six weeks cessation of athletic activity. I do know that Ben R. from Pittsburg played football like eleven days after an appendectomy, and someone from VT played in a game like nine days after one.

I'll certainly not bike this week, then I'm going to New Orleans with my wife for a conference of hers, so I won't bike then, either. But the third week? I'd have to think I could at least do some easy riding, maybe a light workout in the safety of my garage on rollers.

Anyone with any personal experience?
Thanks in advance,
Kevin

40-Dan

LOL - when I saw the title of the post, I was going to mention that VT player (GO JACKETS!!!! BTW)

In other words, I really don't have any useful information to add. My appendix is still firmly in place.

Dan

Miller2

I'd wager you would get a better answer from your doctor. Bike Forum members are probably not qualified to comment on surgery recovery time....except for Dr. Pete.

Snicklefritz

Talk with your doctor and be very specific about what type of workouts you would like to do.
They may not necessarily say "it is ok to exercise after 2 weeks" (or whatever) because if you say that
to some athletes, they will go out immediately and start hammering.

Make up some ideas for workouts you are thinking of doing, like 1 hour easy spinning at HR = x% of Max HR, 1 hour on rollers or whatever. That way your doctor will know exactly what you are thinking. You might get a more specific response from them if you give them more info.

yobtah

I had a laparoscopic appendectomy in late July. After the first few days, your primary concern should be your abdominal muscles. Despite the "minimally invasive" procedure, the surgeons make cuts through the muscles, and those can easily become hernias if you're not careful.

In my case, my doctor basically told me avoid lifting anything heavier than 15 lbs. and to avoid motions that would twist my abdomen sharply (such as swinging golf clubs). Aside from those restrictions, I could do as much as had the energy to do. I started with some light running about one week after the procedure, and I worked up to biking approximately two weeks after that. Your doctor will probably instruct you to keep the incisions clean and dry for a while. This was part of the limitation for me... I didn't want to sweat a lot on the incisions until they had closed and more or less healed.

Biking itself didn't seem to be a problem, but I didn't like the idea of an unexpected fall or emergency manuever. I waited until I felt relatively comfortable moving quickly if absolutely necessary.

After the procedure, your doctor will likely give you more instructions. If you follow those and do what you feel comfortable doing, you should be fine.

VanceMac

On the one hand, some light spinning (as mentioned by fritz) seems FAR safer than the kind of jarring movement and impact Roethlisberger subjected himself to just 2 weeks after surgery. On the other hand, I'm guessing you don't have access to the HGH and other drugs he does. (Nor the hovering medical attention.)

DrPete 

Yobtah pretty much covered it, but I figured I'd add a little something.

There is a very small hernia risk, but it's there. The safe estimate would be to avoid heavy lifting for 4 weeks. That would include any hard riding beyond low-intensity recovery riding (you'd be amazed how many activities actually put pressure on your abdomen).

Laparoscopic surgery, appendectomy included, tends to reduce that recovery time, so you would probably be OK after 2 weeks. But I would definitely check with your surgeon, because he/she was the only one who saw everything, and knows what type of skin/fascial closure was used, what size ports, etc. In general, though, normal activity in 2 weeks is pretty normal. I'd probably say stay off the bike for the first week, then ride VERY easy the next if you really want to. For less active people, I'd tell them to lay off for at least 2 weeks.

Another question--was your appendix ruptured, or was it caught in time? This is assuming, of course, that you had appendicitis.

kseavey

Thanks for the post, Dr. Pete. To answer your question, my appendix wasn't ruptured. It was in the "early" stages. After an overnight bout of pain/nasea/vomiting, I actually felt fine enough to leave after the catscan, but I guess they figured while I was there...

I actually had some wierd, lower grade stomach pains like two months ago, then some even before that. Had pain in the lower-right, some pain in the nads when jumping up and down, etc. I guess it was the appendix acting up, then somehow going back into check. I guess it had had enough this past week.

Thanks again,
Kevin

DrPete 

...they should save your life? Perforated appendicitis is a totally different animal from non-perforated, and if it progresses to that stage it can kill you. And even if it's not lethal, that overnight stay can turn into weeks, there's a very high risk of abdominal abscess formation, and life can be really miserable. In fact, the pain going away is often the first sign of rupture. That's why all appendicitis is treated as quickly as is safe for the patient, and why I'm very glad yours is now in a specimen container somewhere.

As far as your previous pain goes, it's hard to say but many believe there is such a thing as chronic appendicitis, but it's an area of controversy. I'm a believer, so I do think you could attribute the pain you were having to appendicitis. Hernias are on the list too, but the nice thing about laparoscopic surgery is that they probably got a look at that too.

Did you get a CT scan before surgery? I'm just curious...

kseavey

The doctor originally thought it was just food poisoning or something like that. He was almost going to let me go w/o a CAT scan and surgery, but I asked for the scan just to be sure. I had already drank the contrast at that point. They found on the CAT scan that the appendix was slightly inflamed or something like that.

Thanks,
Kevin

DrPete 

If it's one thing I've learned, it's that appendicitis can definitely sneak up on you. I've done appendectomies on patients who scarfed down Big Macs right before coming to the ER and had some horrible appendicitis. A lot of it has to do with where the appendix is and what it's close to, because the type of pain you have is very dependent on that. Thankfully, CT has emerged as a great way to catch the cases that may have gone on to perforate even 10-15 years ago...

I totally agree with you--if you're going to drink that foulness you may as well use it.

Glad to hear it all worked out!

Bontrager

If it was a lap appy they probably used a 5mm scope. 10mm is for amateurs With that being said, I'd rather have a good, very old surgeon do it open.

Lap appy and choles don't get too much attention on closure except a few non-absorbably sutures on the larger ports. Some guys/gals barely throw a few Vicryl knots in the accessory ports.

Did you tell your surgeon you're an athlete? If you did s/he might have thrown a few more sutures in the fascia and sub-q in just for good measure and some Dermabond just for good measure

oilman_15106

Ask Big Ben of the Pittsburgh Steelers - 10 days from surgery straight to 2 losses.

DrPete 

If your 5mm scope is of a newer generation and actually has decent optics, I agree that you can use a 5 scope. Problem is a lot of institutions still have crappy 5mm scopes that just don't work as well as a 10.

Being somewhere with good scopes, I'll usually do a 10 up high and two 5's in the left lower quadrant, and use a 5mm scope. That way there's no switching scopes when I bring the stapler and the Endo-Catch in through the 10 port.

For a young, healthy patient, there's no need to do anything extra with the 10 port besides good fascial closure. Depending on the patient, you can use an Endo-Close to throw some vicryl across it, or if you used a Hasson technique for access you just close it under direct visualization. And the fascial incision for a 5mm port is so tiny that the hernia risk is vanishingly small.

I personally prefer doing appy laparoscopically, but in young healthy patients there's no great data showing an advantage. I think it does afford better visualization of the pelvis and a better washout in perforated cases, and is also helpful in cases where there's some doubt as to the diagnosis, because you can explore much more thoroughly laparoscopically than you can through a little Rocky-Davis incision.

badkarma

Ahh, you beat me to it!

tate

I had a laparoscopic appendectomy in late April. It ruptured most probably during a 70 mile ride. My appendix was located in a very rare position, so I never felt any sensation of sickness for several days. By the time the appendectomy took place, the appendix was in a state of decay. At least I got a ride named after me.

Anyway, It happend as I said in late April. I missed most of May and a little of July. I tried to come back in May, but ended up with something (staph) that I picked up in the hosptial kicking my butt for a while.

No troubles now though.

Just be patient with yourself and it will all be a memory soon enough.