10 Andover Road
Stapled
Cricopharyngeal Myotomy (Zenker's Repair)
Post-Operative Instructions
Description of the Operation
I
will be doing a Stapled Cricopharyngeal
Myotomy (also called a Zenker's Diverticulectomy) for you. This involves dividing the sphincter muscle at the
upper end of your
esophagus. The sphincter doesn't relax normally right now and is responsible for a large
part of your swallowing trouble. The operation also divides the wall between the
Zenker's diverticulum and esophagus to prevent food and secretions from building
up in that pouch. I can usually do this operation using a video camera in the
mouth without making an incision. Be prepared to spend one night in the hospital
although you'll probably be able to go home after just a few hours, depending upon how you feel after
surgery.
Your Recovery
Because of the way your operation will be performed, I'll put little or no
restrictions on your physical activity after the operation. Your level of
discomfort should prevent you from over-exerting yourself. Your discomfort will most likely
be limited to a sore throat and will fade rapidly, so you should be able to return to normal
activities within a few days, depending on the activities. You
may resume showering immediately.
Pain Relief
1. Take Extra Strength Tylenol (or generic acetaminophen) 500-1000mg every 4 hours
as needed to control discomfort.
2. Take Advil (or generic ibuprofen) 600mg every 6 hours
as needed for discomfort not controlled by Tylenol. [DO NOT use Advil if you have a history of
stomach or intestinal ulcers or have had problems taking aspirin in the past.]
3. Take 1-2 oxycodone 5mg tablets every 3 hours as needed for discomfort that
remains after taking Tylenol & Advil. Most people will not need this, so you might
choose not to fill the prescription. This is a narcotic pain killer. If you use
it you must beware of becoming drowsy or inattentive, and you will not be able
to drive or operate dangerous equipment. It can also cause nausea and
constipation.
The above combination is for maximum pain control. You may skip some or all of the medications if you're comfortable without them.
Other Medications
Resume
taking your usual medications unless I instruct you otherwise.
Most Frequent Problems
Sore
throat - Everybody
has this to some degree. It should resolve within a few days. Occasionally the
uvula (little piece of flesh that dangles from the back of the throat) will
swell up and be annoying for a week or two, but it is not a health problem.
Trouble swallowing - You should notice immediate improvement in your swallowing. You may still have some difficulty swallowing solid foods initially and possibly always. You will go home on a liquid diet and can advance it on your own. Most people should resume eating as though nothing has changed and gradually increase what they eat as they gain confidence that swallowing actually is better. At first, chew thoroughly and eat slowly. In general, the bigger the diverticulum is and the more difficulty swallowing before surgery, the greater will be the immediate improvement after surgery.
Nausea
- If you feel okay when you leave the hospital but start to feel nauseated at
home, it is probably caused by the prescription pain killer. You might want to
take only the Tylenol and Advil in that case or call me for a different
prescription (which might also causes nausea). Prolonged vomiting or dry
heaves soon after surgery puts more stress on the operation than I'd like.
Reasons to Call Me
1. Pain not controlled by your medication.
2. Persistent vomiting or dry heaves
3. Fever and redness on your neck or the sensation that there is air under your skin when you massage your neck with your hand.
4. Any questions or concerns what-so-ever
Pre-Operative Appointment (if required)
Location: Date: Time:
Surgery Appointment
* Please start on a liquid diet a day before surgery so your diverticular pouch won't
still have solid food in it during the operation. Don't eat or drink anything at
all after midnight before surgery (except to take your usual medications).
Location: Date:
Arrival Time: Surgery Time:
Post-Operative Office Appointment
Date: Time:
I would like to see you in 3-4 weeks. Please call to confirm your
appointment or to arrange one if you don't have a date & time yet. If you
don't live near Portland and would like a telephone call instead of an office
visit just let us know a few days before your appointment.
Last updated 4/7/07