What causes abdominal pain after minimally invasive surgery for appendicitis?

Abdominal pain after minimally invasive appendectomy may be caused by postoperative recovery of intestinal peristalsis, residual gas in the abdominal cavity, intestinal adhesions, acute enteritis, or intestinal spasms. Symptoms can be improved through adjusting body position, local care, and medication. If abdominal pain progressively worsens or is accompanied by vomiting, cessation of flatus, or bowel movements, prompt medical attention is required.

1. Recovery of postoperative intestinal motility: After minimally invasive surgery, intestinal function gradually recovers. Enhanced peristalsis can stimulate intestinal smooth muscle, causing intermittent abdominal pain, often accompanied by bloating and increased flatulence. It is recommended to turn over appropriately in bed or walk slowly after getting out of bed to promote coordinated intestinal motility. Gently massaging the abdomen in a clockwise direction may also help relieve pain.

2. Irritation from residual intra-abdominal gas: During minimally invasive surgery, gas is introduced into the abdominal cavity. Residual gas after surgery may irritate the intestines and peritoneum, leading to abdominal pain, usually localized in the lower abdomen, which may worsen with deep breathing or changes in body position. Adopting a semi-recumbent position or engaging in light walking helps expel the gas. Applying warm compresses to the abdomen (with appropriate temperature) can also reduce irritation.

3. Intestinal adhesions: Post-surgical adhesion between the intestines and surrounding tissues can cause abdominal pain when intestinal movement leads to traction or obstruction. This is often associated with bloating and difficulty passing stool, with pain intensifying cyclically along with peristalsis. Patients may take medications such as belladonna tablets, raceanisodamine tablets, or lactulose oral solution under medical guidance to alleviate symptoms.

4. Acute enteritis: Reduced immunity after surgery, combined with unhygienic diet or cold exposure to the abdomen, may lead to bacterial or viral infection of the intestine, resulting in acute enteritis. Inflammation irritates the intestinal mucosa, causing abdominal pain accompanied by diarrhea, nausea, and sometimes low-grade fever. Under medical supervision, medications such as norfloxacin capsules, montmorillonite powder, or oral rehydration salts III may be used to manage symptoms.

5. Intestinal spasm: Improper diet (such as consuming greasy food too early) or emotional stress after surgery may trigger strong contractions of intestinal smooth muscle, leading to intestinal spasm. This causes sudden, severe, and episodic abdominal pain, with no significant discomfort once the episode subsides. Medications such as atropine sulfate tablets, butylscopolamine bromide capsules, or pinaverium bromide tablets may be used as directed by a physician to relieve symptoms.

For daily care, maintain a light diet, progressing gradually from liquid to normal food; keep the abdomen warm to avoid cold exposure; follow a regular sleep schedule and avoid fatigue to support stable recovery of intestinal function.