How to Manage Pain After Your Robotic or Laparoscopic Abdominal Surgery

A POI means that it takes your intestines longer to recover from anesthesia than the rest of you. The slowdown can be mild, or it can be severe enough to need medical treatment.

Passing Gas After Abdominal or Other Types of Surgery

Why focus on passing gas after surgery? If you can’t pass gas, it could mean you are developing a condition called post-operative ileus (POI). POI means your intestines are not moving food through your body properly.

There is a risk of POI following abdominal surgery and some other types of surgeries. This condition can lead to a serious infection, such as peritonitis and sepsis, or complications associated with not eating by mouth, electrolyte imbalances, and malnutrition.

After surgery, you may be told to let your nurse know if you pass gas.

Verywell / Brianna Gilmartin

This article explains why it’s important to pass gas after surgery and what it could mean if you cannot.

Importance of Gas After Surgery

You may have anesthesia to put you to sleep during surgery. The medication can slow down or even stop the gut from moving food and waste from your stomach through the digestive tract. When this slowdown happens, it’s called a delay in gastric motility or POI.

A POI means that it takes your intestines longer to recover from anesthesia than the rest of you. The slowdown can be mild, or it can be severe enough to need medical treatment.

The ability to pass gas is a clear sign that your digestive system is waking up. If you can pass gas, you either didn’t have a POI, or it is improving.

You may have had a bowel preparation to clean the stool out of your body before surgery. If so, it may be several days before you have a bowel movement. Gas may pass long before a stool does, showing that your bowels are working well.

If you had outpatient surgery, your healthcare team may even require you to pass gas before you go home. The staff doesn’t want to send you home with a POI that could become serious. That’s the reason it’s important to let them know when you pass gas.

Symptoms

A delay in gastric motility is usually brief. A more severe POI may call for a longer hospital stay. Severe symptoms can include:

Nausea
Bloating
Vomiting
Abdominal tenderness or pain
Delayed or stopped passing of gas/stool

Sometimes people have nausea, vomiting, and pain after surgery. Because these symptoms can have different causes, it’s a good idea to talk to your healthcare provider any time you have these symptoms while you are recovering.

Reasons You Can’t Pass Gas After Surgery

Researchers have several theories about why postoperative ileus happens. POIs may be caused by different factors in different people.

Abdominal Surgeries

One theory is that POI happens when your intestines are handled during surgery. For example, your surgeon may move them out of the way to reach other body parts. Or you may have had surgery directly on your intestines.

If your intestines were handled, your body’s immune system may be triggered. White blood cells and other types of cells may rush to the area, causing a slowdown.

Disruption to the Nervous System

Another theory involves your nervous system. Your nervous system has two “departments.” The sympathetic nervous system (SNS) normally makes your intestines move less. The parasympathetic nervous system (PNS) makes your intestines move more. After surgery, your SNS may have more control for a short time.

Electrolyte Imbalance

Surgery and fluid and electrolyte over-replacement post-surgery can cause an imbalance in your electrolytes. Electrolytes (such as potassium and calcium) are minerals needed for key functions in the body, such as normal digestion.

Side Effect of Medication

It’s also possible that pain medications could raise your risk of a POI. Opioid medications can cause constipation after surgery. If you are taking opioid medications for pain relief, or if you already had issues with your intestines before this surgery, you have a higher risk of developing POI.

Prevention

Preventing a POI is not always possible, but there are ways to lower the risk.

People who receive anesthesia by an epidural in their spine typically recover faster from a POI. Lighter types of anesthesia usually cut down on the risk of POI.

Less-invasive surgeries also have a lower risk of POI. These procedures typically use tools inserted through small incisions, such as laparoscopy. POIs may not last as long as they might with open surgeries with larger incisions. That may be because you are under anesthesia for a shorter time and there is less disruption to your body.

Summary

Passing gas after surgery is important. If you can’t pass gas soon after surgery, it may mean that a post-operative ileus, or gastric delay, is happening.

A post-operative ileus or POI occurs when there’s a slowdown in your body’s ability to digest food. It could be caused by changes in your nervous system or the after-effects of having your intestines handled. A POI could even happen because of the medications you’re taking.

To lower your risk, maintain a healthy diet, and try chewing gum or walking after surgery.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Buchanan L, Tuma F. Postoperative ileus. In: StatPearls. StatPearls Publishing; 2023.
Sanfilippo F, Spoletini G. Perspectives on the importance of postoperative ileus. Curr Med Res Opin. 2015;31(4):675-6. doi:10.1185/03007995.2015.1027184
Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC. Ileus in adults. Dtsch Arztebl Int. 2017;114(29-30):508–518. doi:10.3238/arztebl.2017.0508
Venara A, Neunlist M, Slim K, et al. Postoperative ileus: Pathophysiology, incidence, and prevention. Journal of Visceral Surgery. 2016;153(6):439-446. doi: 10.1016/j.jviscsurg.2016.08.010
Bragg D, El-Sharkawy AM, Psaltis E, Maxwell-Armstrong CA, Lobo DN. Postoperative ileus: Recent developments in pathophysiology and management. Clin Nutr. 2015 Jun;34(3):367-76. doi: 10.1016/j.clnu.2015.01.016

By Jennifer Whitlock, RN, MSN, FN
Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.

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How to Manage Pain After Your Robotic or Laparoscopic Abdominal Surgery

This information explains ways to manage pain after your robotic or laparoscopic (LA-puh-ruh-SKAH-pik) abdominal surgery. You can do these along with or instead of taking pain medication.

About robotic or laparoscopic abdominal surgery

During your robotic or laparoscopic abdominal surgery, your doctor will put gas into your abdomen (belly). This makes room for your surgeon to see the inside of your abdomen.

Ways to manage pain after robotic or laparoscopic abdominal surgery

Your care team will give you pain medication after your surgery. If it doesn’t control your pain, tell your healthcare provider. You can also do these things to help:

Listen to music with headphones

If you own a pair of headphones that you like, bring them to the hospital. You’ll also get a pair at the hospital.

Move your legs

While you’re in bed:

Bend and straighten your legs.
Bend your knees and put your feet flat on the bed. With your legs together, gently rock your knees from side to side.

While you’re in the hospital

Try to start walking within 4 hours of your surgery. While you’re in the hospital, walk every 1 to 2 hours while you’re awake, if you can. A staff member will help you.

At home

After you leave the hospital, keep walking at home if you can. If you need help, ask your caregiver.

Drink mint or ginger tea

Drinking tea can help pass the gas causing pain or discomfort after your surgery.

Use a hot or cold pack

If you have shoulder or abdominal pain, ask a nurse for a hot or cold pack. A hot pack improves blood flow to the area and can relax and soothe the muscles. A cold pack can reduce swelling and numb the pain.

Do not put the hot or cold pack directly on your skin. Wrap it in a towel or cloth and put it on the painful area. Leave the pack on the area for up to 20 minutes, then take it off for at least one hour.

Get rest and sleep

Getting rest during the day and sleep during the night can help ease your pain after surgery. If you can, have quiet time alone in your room.

Meditate

These meditation videos may help you. You can watch them online or on the TV in your hospital room:

Managing Pain with Meditation: A Guided Visualization (Robin Hardbattle)
Mindful Breathing Meditation (Emily Herzin)
Day at the Beach: A Guided Visualization (Robin Hardbattle)
Grassy Meadow: A Guided Visualization (Robin Hardbattle)

Use acupressure

Acupressure is when you use your fingers to apply pressure to specific places on your body. Watch Acupressure for Pain and Headaches online or on the TV in your hospital room for more information.

Ask for touch therapy

Talk with a nurse before asking your caregiver for touch therapy (massage). They can tell you if you should avoid massaging any areas of your body. Watch Touch Therapy for Caregivers online or on the TV in your hospital room for more information.

When to call your healthcare provider

Call your healthcare provider if you still have pain after trying these things and pain medication doesn’t help.

If you have questions or concerns, contact your healthcare provider. A member of your care team will answer Monday through Friday from 9 a.m. to 5 p.m. Outside those hours, you can leave a message or talk with another MSK provider. There is always a doctor or nurse on call. If you’re not sure how to reach your healthcare provider, call .

For more resources, visit www.mskcc.org/pe to search our virtual library.

How to Manage Pain After Your Robotic or Laparoscopic Abdominal Surgery – Last updated on September 21, 2023
All rights owned and reserved by Memorial Sloan Kettering Cancer Center

How To Get Rid Of Gas After Surgery

How to Manage Pain After Your Robotic or Laparoscopic Abdominal Surgery

Passing Gas After Abdominal or Other Types of Surgery

Importance of Gas After Surgery

Symptoms