Patient Resources

Recovery Guide

What to expect after your procedure — pain management, wound care, activity timelines, diet, and when to call the office. For all robotic and minimally invasive surgeries.

What to expect

Pain Management — Our Approach

Dr. Kakarla uses a multimodal, non-opioid-first approach to pain management that follows Enhanced Recovery After Surgery (ERAS) protocols. The goal is effective pain control with minimal narcotic use.

How We Manage Pain

TAP block or nerve block — given during surgery to numb the abdominal wall for 12–24 hours. This is why many patients wake up with little to no pain.
Tylenol (acetaminophen) — 1000mg every 6 hours around the clock for the first 3–5 days. This is your primary pain medicine.
Ibuprofen (Advil/Motrin) — 400–600mg every 6 hours, alternating with Tylenol. Anti-inflammatory effect helps with surgical swelling.
Prescription narcotic (backup only) — a small prescription is provided for breakthrough pain. Most patients use fewer than 5 pills total.
Ice packs — 20 minutes on, 20 minutes off over the surgical area for the first 48 hours. Reduces swelling and provides comfort.

Do not use heat on the surgical area for the first 2 weeks — heat increases swelling and bleeding risk. Ice only.

Shoulder Pain After Robotic / Laparoscopic Surgery

Many patients experience shoulder tip pain after surgery — this is normal and not a complication. It is caused by CO2 gas used to inflate the abdomen during surgery irritating the diaphragm, which shares a nerve pathway with the shoulder.

Usually appears 12–24 hours after surgery
Lasts 1–3 days, occasionally up to a week
Walking helps the gas absorb faster
Lying flat can make it worse — try sleeping propped up
Gas-X (simethicone) may help with associated bloating

Incision care

Wound Care & Incision Instructions

What to Expect

Robotic surgery uses 3–5 small incisions (typically 8–12mm each). They are closed with one of the following:

Dermabond (skin glue) — peels off on its own in 1–2 weeks. Do not pick at it.
Steri-Strips (adhesive strips) — fall off on their own in 7–10 days. If edges curl, trim with clean scissors. Do not pull them off.
Absorbable sutures — dissolve on their own. No removal needed.

There are no staples and no stitches to remove in most robotic procedures.

Showering

Shower after 48 hours — let water run gently over incisions
Pat dry — do not rub or scrub the incisions
No baths, swimming pools, or hot tubs for 2 weeks (soaking increases infection risk)
Do not apply hydrogen peroxide, alcohol, or antibiotic ointment unless instructed

What Is Normal

Mild redness around incisions — normal
Bruising around or away from incisions — normal (blood tracks along tissue planes)
Small amount of clear or slightly pink drainage — normal
Firm, smooth lump under an incision (seroma) — common, usually resolves in 4–6 weeks
Numbness around incisions — normal, may take months to fully resolve
Itching as incisions heal — good sign, means healing is progressing

Signs of Infection — Call the Office

Increasing redness that spreads outward from the incision
Warmth and tenderness that is getting worse, not better
Thick, cloudy, or foul-smelling drainage (pus)
Fever above 101.5°F (38.6°C)
Red streaks extending from the incision

Call (770) 962-9977 immediately. Our 24/7 answering service is available nights and weekends.

Scar Care (After Incisions Are Fully Closed)

Sunscreen on scars for at least 12 months — UV exposure causes permanent darkening
Silicone scar sheets or gel (ScarAway, Mederma, etc.) starting at 2–3 weeks can help flatten and fade scars
Massage the scar gently once fully healed to prevent adhesion
Scars continue to fade and soften for 12–18 months
Robotic incisions are small (8–12mm) and typically become barely visible

Getting back to life

Activity & Return to Normal

These are general guidelines. Your specific timeline may vary based on your procedure and how you feel. Dr. Kakarla will give you personalized instructions at discharge and follow-up.

Walking & Movement

Start immediately. Short walks around the house the evening of surgery. Increase gradually every day. Walking is the single best thing you can do for recovery — it prevents blood clots, reduces gas pain, improves bowel function, and speeds healing.

Activity Timeline (Typical for Robotic Surgery)

Driving — when you are off narcotic pain medication and can perform an emergency stop without pain. Usually 3–5 days for hernia/gallbladder, 7–10 days for more complex procedures.
Desk work / work from home — 3–7 days for most outpatient procedures
Light physical work — 2–3 weeks
Heavy physical labor — 4–6 weeks
Lifting restriction — nothing over 10–15 pounds for 4 weeks. This includes children, pets, groceries, and laundry.
Exercise / gym — light cardio (walking, stationary bike) at 2 weeks; full exercise at 4–6 weeks
Running / jogging — 3–4 weeks
Yoga / Pilates — 4 weeks (core engagement exercises)
CrossFit / heavy lifting / contact sports — 6 weeks
Sexual activity — when comfortable, typically 1–2 weeks. Let pain be your guide.
Swimming — 2 weeks (incisions must be fully closed)
Air travel — generally safe after 1–2 weeks for short flights. Walk the aisle hourly. Stay hydrated. Compression stockings recommended for flights over 3 hours due to increased blood clot risk after surgery.

Sleep Position

Back or slightly reclined is most comfortable for the first week
A recliner works well — easier to get in/out than a flat bed
Pillows under the knees reduces tension on abdominal muscles
Side sleeping is fine when comfortable, usually after a few days
Stomach sleeping — wait 2–4 weeks
Use a pillow to splint your abdomen when coughing, sneezing, or laughing

Nutrition

Diet & Digestion After Surgery

General Guidelines (Most Procedures)

Day of surgery: Clear liquids, broth, Jell-O, popsicles
Day 1–2: Bland, light foods — toast, crackers, soup, bananas, yogurt, applesauce
Day 3+: Gradually return to your normal diet as tolerated
Avoid greasy, spicy, or heavy foods for the first week
Eat small, frequent meals rather than 3 large ones
Stay well hydrated — aim for 8 glasses of water daily

Constipation Prevention

Constipation is extremely common after surgery due to anesthesia, pain medications, and reduced activity. Prevent it proactively:

Colace (docusate sodium) — start the day you get home, 100mg twice daily
MiraLAX (polyethylene glycol) — one capful in water daily if Colace alone is not enough
Walk regularly — movement stimulates the bowel
Drink plenty of water and eat fiber-rich foods when you can tolerate them
Minimize narcotic use — opioids cause constipation. Switch to Tylenol/ibuprofen as soon as you can.

If you have not had a bowel movement by day 4 after surgery, call our office.

Alcohol & Coffee

Alcohol: Avoid for at least 1 week, and do not drink while taking narcotic pain medication. Alcohol thins blood and impairs healing.
Coffee: Small amounts are generally fine after day 1–2 for most procedures. After fundoplication, follow the specific diet progression (decaf initially, regular coffee after 6–8 weeks).
Carbonated beverages: Avoid for 1–2 weeks — can cause bloating. After fundoplication, avoid for 6–8 weeks.

Mind & body

Emotional Recovery

Surgery is a physical and emotional event. It is normal to experience a range of feelings during recovery.

Fatigue is the most common complaint. Your body is using energy to heal. Naps are fine and expected for 1–2 weeks.
Mood changes — irritability, tearfulness, or feeling “down” for a few days after surgery is common. General anesthesia, disrupted sleep, pain medications, and limited activity all contribute.
Frustration with restrictions — active patients often struggle with the lifting and exercise restrictions. Remember they are temporary and protect your repair.
Anxiety about recovery — worrying that every sensation is a complication is normal. Most post-surgical sensations (twinges, pulling, itching, swelling) are signs of healing, not problems.

If feelings of depression, hopelessness, or anxiety persist beyond 2 weeks, or if they interfere with your daily life, talk to your primary care physician. This is treatable and nothing to be embarrassed about.

Important

When to Call the Office vs. Go to the ER

Call Our Office (770) 962-9977

Fever above 101.5°F
Increasing redness or drainage from incisions
Pain that is worsening after day 2–3 instead of improving
Cannot keep food or liquids down for 12+ hours
No bowel movement for 4+ days
New bulge at or near the surgical site
Questions about medications, diet, or activity
Leg swelling or calf pain

24/7 answering service available. You will always reach someone who can help, even nights and weekends.

Go to the ER or Call 911

Severe, sudden abdominal pain
Heavy bleeding from an incision that does not stop with pressure
Chest pain or difficulty breathing
Signs of allergic reaction (swelling of face/throat, difficulty breathing, hives)
Loss of consciousness
High fever with chills and confusion

Questions About Your Recovery?

Don’t hesitate to call — no question is too small. We’re here to help you heal.

Call (770) 962-9977 Request a Callback

Northside Hospital questions? For post-discharge questions related to your hospital stay, call the Northside Pre-Surgery Line: (678) 312-2443. For questions about your surgical care and recovery, call Dr. Kakarla’s office: (770) 962-9977.