The short version
- One larger incision on the abdomen, either up and down or along the bikini line.
- Usually one to three nights in the hospital.
- Most dressings come off on day 7. A negative pressure dressing comes off when it beeps and loses suction, usually day 5 to 7. [1]
- No lifting over 15 to 20 pounds and no core exercise for 6 weeks. Pelvic rest for 12 weeks. [1]
- The recovery rules are the same as for robotic surgery. What differs is the first week.
Your own discharge papers come first
Everything on this page is taken from the standard printed instructions this office gives patients. If the papers you were handed at discharge say something different, follow those. They were written for your operation. When the two disagree, call the office at 817-759-7065 and let us settle it.
After laparotomy or laparoscopy
The instructions you were given at discharge, in case the paper copy has gone missing.
Why open is sometimes right
A minimally invasive operation is not automatically the better one. An open incision is chosen when the tumor is large, when disease is spread through the abdomen and has to be removed from several places, when scarring from previous surgery blocks the view, or when the anatomy makes the robotic approach unsafe.
For advanced ovarian cancer in particular, the goal of surgery is to remove all visible disease, and that often means working in several areas of the abdomen at once. [2] The incision is what makes that possible.
An operation can also start robotically and be converted to open. That decision is made in the moment, for safety, and it is a good decision when it happens.
The incision
A vertical incision runs from near the navel down toward the pubic bone. A transverse one runs across the lower abdomen along the bikini line. Which one depends on how much of the abdomen has to be reached. For gynecologic cancer, a vertical incision is common because it gives access to the upper abdomen.
Wash the incision with warm soapy water and keep it clean and dry. [1] Bruising and tenderness around the incision, and abdominal tenderness generally, are common. [1]
In the hospital
Expect one to three nights. The team will have you out of bed and walking the day of or the day after surgery, and that is not enthusiasm, it is prevention. Walking is the best protection against blood clots and pneumonia, and it helps the bowel wake up.
Eating usually restarts gradually. Some bloating and gas pain is expected, and simethicone after meals helps. [1] Avoid foods that tend to give you gas. [1]
Recovery week by week
- Pain medicine. Alternate Tylenol and ibuprofen every 3 hours as needed. Up to 600 mg of ibuprofen every 6 hours, and up to 650 mg of Tylenol every 6 hours. Prescription medicine is for breakthrough pain. [1]
- Driving. No driving for the first 1 to 2 weeks, and none while you are still taking prescription pain pills. Do not drive if abdominal pain slows your reaction time. [1]
- Bathing. Shower the day after surgery. Avoid tub baths, swimming, and hot tubs for about 2 weeks or until you are cleared at your post-operative visit. [1]
- Activity. Avoid strenuous exercise until your physician clears you. Avoid core exercises for 6 weeks. Walk every 1 to 2 hours in the days after surgery. [1]
- Bleeding. Vaginal spotting is normal up to 12 weeks after surgery. [1]
When to call
When to seek care right away
Call the office now, or go to the emergency department, if you have:
- A fever of 101 degrees Fahrenheit or higher
- Chest pain or shortness of breath
- Nausea and vomiting you cannot get on top of
- Increased pain, swelling, redness, or drainage from an incision
- Bleeding through more than one pad an hour
- Vaginal discharge with a foul odor
- Trouble emptying your bladder, or burning when you urinate
- Increasing swelling in one leg
After laparotomy or laparoscopy
The printed instructions given after open abdominal surgery.
Sources
- Vasques DR. Post Laparotomy or Laparoscopy Instructions. The Center for Cancer and Blood Disorders, Fort Worth, TX. Patient handout supplied by the practice. pdfs/after-laparotomy-or-laparoscopy.pdf
- National Cancer Institute. Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ) Patient Version. Updated November 22, 2024. https://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq
Reviewed by DeEtte R. Vasques, DO, MBA · September 2026