Concerned with pain management with diastasis recti repair?

Question

I am scheduled for an endoscopic diastasis recti repair. I have a well respected plastic surgeon that will doing this procedure at a very reputable hospital. He has 30+ years of experience and I really Ike Jim. My concern is that he doesn't use exparel or a pain pump....only vicadin. This procedure will be done outpatient and it's a 2 hour drive from where I live. He says I'll be fine but I'm concerned that the post op pain management will be insufficient. Am I overreacting?

Ricardo L. Rodriguez, MD · Answer

Dear Alice-- I am a big fan of pain pumps following abdominal surgery, but since it is an extra cost to the patient, some patients choose not to have the pain pump.   While you will definitely have more pain,  prescription pain meds will reduce the pain dramatically.  Express your concerns about the strength of the pain med in your pre-op appointment, or call the office.   They may suggest that you try the vicadin after surgery, and call back to get something stronger.  Thus, overall, it should not be a problem and your pain should be manageable. Good luck!Ricardo L Rodriguez MDBaltimore, Maryland

Richard Baxter, MD · Answer

Often the diastasis repair is the most significant pain control issue with tummy tuck, so my personal preference would be to use Exparel even when the full tummy tuck is not done. Your surgeon can iject a numbing agent called Marcaine (bupivacaine) which will last a few hours but Exparel lasts up to 3 days.

Jeffrey E. Schreiber, MD, FACS · Answer

If you're concerned about the pain, make sure you speak with your plastic surgeon prior to your surgery.  You might need something a little stronger just in case.

John P. Stratis, MD · Answer

Pain and reaction to pain are very personal and idiosyncratic. As such some methods of pain management work great on some people and not so well on others.The use of oral pain medication, possibly supplemented with local anesthesia injections at the operative site during the surgery, have been used for years with great success. The use of a pain pump and the exparel are recent and do decrease the amount of pain medication that is used after surgery. The problem is that they do add expense to the procedure. If the patient or the doctor are willing to bear that expense they do add to the comfort level. Ultimately, do not be afraid even without these modalities. Pain pills have been the mainstay of pain management after a tummy tuck. Speak to your Dr regarding your concerns and see what he has to say also.

Melinda Lirag Lacerna-Kimbrell, MD, FACS · Answer

thanks for your question.  If your surgeon does not use exparel or on q pain pump, you can ask him or her to inject Marcaine long lasting anesthetic to your muscles or fascia, then start taking flexeril and Percocet when you get home.  The Marcaine lasts about 4 hours so this can help during the drive home! Good luck and take care!

Concerned with pain management with diastasis recti repair?

Answers (5)