Medical care at present is very different than treatment just 2 decades ago.  Widespread use of minimally invasive therapy as default concept elevates client expectation.  Well, people anticipated bad pain after surgery in the old days.  Now, sometimes it is not an overstatement to say that an occasional  patient expects that he might fight a boxing match soon after minimally invasive surgery.

It is very important to prepare patients before operation about ‘minor’ discomfort after operations.  After general anaesthesia, it is usual to feel that the throat is dry.  There is difficulty with talking.  Occasionally there is minor break in mucosa (skin inside) of the mouth, crack in the lips, gum discomfort or even teeth loosening.  All of these relate to tools such as tubes passed down the airway.  They are used to allow an anaesthetized patient to breathe, and to protect the airway.  The airway is not designed to allow foreign bodies, of course, and immediately after surgery there is discomfort.  It is possible to loosen teeth or break oral mucosa when doctors have to put instruments down the airway within a short time.  It does not necessary mean that the doctors did anything wrong even when there is discomfort.  Usually the discomfort goes away quickly.

It is common to feel like throwing up, called nausea, or actually vomit, after anaesthesia. It is minor and usually stops by itself, whether drugs are used or not.  Vomiting is particularly common after laparoscopic surgery, probably in relation to the diaphragm (a sheet of muscle between the tummy and the chest) being pushed up by gas inside the abdomen during operation.

Many a time, there is need to let urine out before, during or after operation.  The urinary bladder is very sensitive and a tube in the pee-passage may cause urges to void, though actually all the urine is already drained off.  It is of course not comfortable, but it may be necessary in relation to need for long stay in bed, to monitor urine output and other reasons.

Wound pain is usually not very severe after minimally invasive surgery.  It may still be helpful to tell patients that dosage of pain killers are calculated to give comfort back safely. It is useful to be pain-free, because pain limits movement and delays sitting, standing or walking.  The human body is used to an upright posture.  Long bed rest interferes with efficient breathing,  and even protection given by coughing, thereby leading to sputum retention.  Long bed rest delays peeing, and leads to more urine infection.  In addition, pain limits movement, and prolonged leg immobilization is related to blood clot formation inside leg veins and thereafter serious problems. Sensible use of pain killers allow the patient to sit and move early.  It encourages recovery.  

There is often need to infuse fluid and drugs into blood vessels (veins). Use of intravenous catheters is associated with pain, and sometimes infection.  Even with the highest level of caution, bacteria infection may occur.  It may be viewed that bacteria do not necessarily obey doctors and nurses.  Sometimes skin nerve fibres are caught during insertion of these catheters, and it is difficult if not impossible to avoid these nerves which cannot be seen.  Then numbness may result, but the problem usually resolves after some time by itself.

Doctors may have to explain before operations that occasionally the operation may not be able to achieve what is targeted.  It is uncommon but possible that a tumor is not fully removed.  The doctor would monitor and examine carefully during and after operation, and should be committed to walking the whole path for recovery together with the patient.  In addition, sometimes the old problem recurs even after successful treatment in the start.  Usually sincerity and openness reassures patients and maintains good doctor-patient relationship.