Posted September 26, 2013. 2021 Aug 29;11(4):e118278. The doctor may recommend that you take a pain medication to help you recover. A randomized clinical trial on the effect of a lidocaine patch on shoulder pain relief in laparoscopic cholecystectomy. Fortunately, the pain usually settles down within a few days. This : This shoulder pain is a common complaint following laparoscopic surgery.This type of pain is called referred pain. While it can be uncomfortable, the pain will pass on its own. Another easy way to alleviate the gas pain is to apply a heat pack to the abdominal area. injury to the shoulder or neck. visceral pain. The PFT results and respiratory discomfort assessed by a modified Borg's scale were not different significantly between the groups. Score: 5/5 (66 votes) . You can also apply a heating pad on the affected shoulder to minimize the pain and discomfort. However, shoulder pain can be caused by stretching of the shoulder, which is constrained by many muscles and ligaments. If you are unable to tolerate the pain, you can ask a nurse to provide you with a narcotic analgesia that will make you sleep. While doctors usually discuss the vagus nerve in singular sense, there are two vagus nerves, one on each side of the neck and in combination they are referred to as the vagal nerves. The phrenic nerve has anatomical connections with the brachial plexus and the shoulder. A proposed mechanism for PLSP is the irritation or injury of the phrenic nerve by the CO2 pneumoperitoneum during laparoscopic surgery. Each person has a different overall response, and hair loss can come and go throughout your life, but there is no known cure 2007 Jul;24(7):596-601. doi: 10.1017/S0265021507000178. A support pillow can also help. Heat packs can also increase swelling, so be sure to take a rest every 20 minutes. Tsai H, Chen Y, Ho C, et al. A sniff test is an exam that checks how the diaphragm (the muscle that controls breathing) moves when you breathe normally and when you inhale quickly. with time this can decrease. Pain occurs in the neck or scapula when the phrenic nerve is irritated 16,17,22. . American Society of Anesthesiologists(ASA) physical status of patient classification I-II. that send pain signals to both the shoulder and the diaphragm, the brain is Injuries to the phrenic nerve can occur in a number of ways, including injections of medicine in the neck prior to shoulder surgery or to treat pain, chiropractic adjustments of the neck, or neck, chest or vascular surgery. Here, we investigated whether a phrenic nerve block (PNB), performed under ultrasound guidance, could reduce the incidence and severity of PLSP after . Phrenic nerve irritation, following a laparoscopic surgery, can impact both motor and sensory functions. Provided for educational purposes only. For example [my story] would show as my story on the Web page containing your story.TIP: Since most people scan Web pages, include your best thoughts in your first paragraph. This video demonstrates surgical repair of the phrenic nerve in a patient diagnosed with right diaphragm paralysis resulting from a prior neck surgery. While laparoscopic surgery is generally regarded as a better alternative to open surgery, it is not without its risks and side effects. In obese patients with short neck, . 2008 Nov-Dec;33(6):545-50 Pleurisy can, in some cases, also lead to coughing and fever. There is a high incidence of shoulder pain after visceral surgical procedures. Some of the gas used to inflate your abdomen can remain inside your abdomen after the procedure, which can cause: These symptoms are nothing to worry about and should pass after a day or so, once the patient body has absorbed the remaining CO2 gas. All images herein are property of the Center for Endometriosis Care except where otherwise noted through direct attribution, licensed usage and/or via permission. Heat and pain medications often bring relief. Home Contact Us Privacy Policy Ad Policy DisclaimersStatement of Diversity & Inclusion:The Center for Endometriosis Care (CEC) fosters a culture of opportunity and mutual respect. Unauthorized use of these marks is strictly prohibited. The investigators will follow the patient in the first 48 hours after the surgery. -, Br J Anaesth. This method can help prevent shoulder pain and can also ease diaphragm pain. Management: . Goldberg J, Falcone T. Gasless Gynecologic Laparoscopy. Retrieved from http://hcp.obgyn.net/laparoscopy/content/article/1760982/1894615, 6105 PEACHTREE DUNWOODY ROADBUILDING B, SUITE 230ATLANTA, GA 30328PHONE: 770-913-0001FAX: 770-913-0005. Gynaecological keyhole surgery (laparoscopy) is a procedure where a surgeon uses a camera (laparoscope) to see inside the lower abdomen to view the uterus (womb), fallopian tubes and ovaries. It can also occur as a result of damage to the peripheral nerves in those areas. What can you not do after laparoscopic surgery. you are worried that the pain in your shoulder after a surgery is due to EMSJen. From acute to chronic postsurgical pain: the significance of the acute pain response. Elevating your head on a pillow can reduce pain. How do I get rid of trapped gas in my shoulder? Novel Regional Nerve Blocks in Clinical Practice: Evolving Techniques for Pain Management. Conclusion: How long does gas pain from laparoscopy last? Fluid instillation and pulmonary recruitment maneuvers are also used to reduce STP. Postoperative pain caused by gas is the most common and most unpleasant experience for patients after laparoscopic surgery. You can use paracetamol or ibuprofen for the pain you experience following surgery. It begins at the C3 vertebra, which aligns with the jaw and rotates the neck. February 2001 Volume 7 Issue 1, 6. Entering your story is easy to do. It can also be affected by surgical procedures. A quick phone call to your doctor is a good idea, and you should explain where the trapped gas is. Decreasing Upper and Shoulder Pain After Laparoscopic Surgery - Full Text View Brief Summary: Laparoscopic surgery is becoming a major procedure, owing to smaller incisions, shorter hospitalizations, and . The incidence of shoulder pain varies from 35% to 80% and ranges from mild to severe. Bring headphones with you. Mechanism of pain: The hypothesis of post-operative shoulder-tip pain is that carbon dioxide induced phrenic nerve irritation causes . Doctors typically diagnose phrenic nerve injury by conducting a physical exam, asking the patient about previous medical treatments that may have affected the neck or chest, and considering whether the patient has severe shortness of breath and is unable to perform simple day-to-day activities. After your laparoscopic surgery, you may be groggy or dizzy. Phrenic nerve irritation, following a laparoscopic surgery, can impact both motor and sensory functions. Has anyone dealt with, dealing with phrenic nerve pain? Listing a study does not mean it has been evaluated by the U.S. Federal Government. Because the lungs are stuck to the thoracic cavity, this expands the lungs and thereby draws air into them. Laparoscopic surgery is becoming a major procedure, owing to smaller incisions, shorter hospitalizations, and less post-operative pain as compared with traditional laparotomies. Postlaparoscopic pain can be separated into distinct causes, such as surgical trauma- or incision wound-associated inflammatory change . Dr. Rahul Poddar. The phrenic nerve stimulation test, also called the phrenic nerve conduction study, uses electric or magnetic stimulation to the neck to measure the response of the phrenic nerve. Bruising after laparoscopic surgery. It provides complete motor innervation to the diaphragm and sensation to the central tendon aspect of the diaphragm. Abdominal surgery can sometimes lead to chronic pelvic or abdominal pain. A proposed mechanism for PLSP is the irritation or injury of the phrenic nerve by the CO 2 pneumoperitoneum during laparoscopic surgery. This gas can irritate the diaphragm and peritoneum, causing pain and discomfort. Laparoscopy - a minimally invasive surgical procedure used to diagnose and treat endometriosis (among many other disorders) Peritoneal tissue - the membrane that forms the lining of the abdominal cavity. Many times the symptoms are temporary, for example, many patients have nerve problems after surgery that only last for a few weeks to months . It is not due to an The incidence of shoulder pain varies from 35% to 80% and ranges from mild to severe. If the pains dont disappear on their own, try taking a stool softener. . In severe cases, it can even result from a spinal cord injury. Unexplained shoulder and arm pain can sometimes be a warning sign of a heart attack. You should also avoid lying flat on your back. This problem is often caused by trapped gas under the rib cage. It passes motor information to the diaphragm and receives sensory information from it. Martinez-Barenys C, Busquets J, de Castro PE, Garcia-Guasch R, Perez J, Fernandez E, Mesa MA, Astudillo J. Eur J Cardiothorac Surg. The Use of Massage Therapy as a Nonpharmacological Approach to Relieve Postlaparoscopic Shoulder Pain: a Pediatric Case Report. An official website of the United States government. This soreness is caused by gas in the shoulder joint, which will go away in two to three days. 3 Interscalene brachial plexus block is the most common regional anesthetic technique; however, phrenic nerve palsy and hemidiaphragmatic paresis have traditionally been inevitable consequences, which limit its utility in the . After surgery, laparoscopic patients may feel groggy and disoriented, and some may even feel sick. So the presented cases may actually underestimate the prevalence of hemidiaphragm paralysis after shoulder surgery. Similarly, other gases can cause similar symptoms. Multiple research studies have hypothesized that PLSP is due to phrenic nerve irritation at the diaphragmatic level, creating referred pain Background: Post-laparoscopic shoulder pain (PLSP) frequently follows a laparoscopic cholecystectomy. This simple exercise will help your body clear any excess mucus. If you are suffering from shoulder pain, you should consult your doctor about treatment options. This is an important piece of information for the health care team to know because they need to know whether your intestines are working properly and whether or not POI is occurring. If you our pain is disturbing enough BMI: 29.6. If it doesn't control your pain, tell your doctor or nurse. It is due to the gas Gas left in the abdomen after laparoscopic surgery can irritate the peritoneum. A variety of factors can irritate the phrenic nerve, including: swallowing and breathing air in at the same time. The primary outcome measure of this trial is the severity and frequency of shoulder and upper abdominal pain after laparoscopic surgery. The phrenic nerve is one of the four major nerves that run through the diaphragm. Have as much rest as possible. A pulmonary recruitment maneuver consisting of five manual pulmonary inflations was performed with a maximum pressure of 60 cmH2O. Used with permission.Appointments are not made online. Sci Rep. 2021 Jan 13;11(1):1052. doi: 10.1038/s41598-020-80289-y. Multiple research studies have hypothesized that PLSP A small amount of it dissolves in the moisture on the surface of the Alternatively, the patient can lie down and watch TV or listen to music. For a few days after the laparoscopic surgical procedure, many patients likely to feel some pain and discomfort, which in turn can irritate the nerve endings in the diaphragm resulting in referred pain in shoulder. This is common and is caused by the accumulation of gas under your rib cage. This can cause pain in the chest, upper chest, and shoulder region. heart rate will be very fast, your blood pressure will be low, you will be It can also settle up under the diaphragm and cause pain in the upper and lower chest. Seating up, standing and walking worsens This type of pain would not go away Great! No content herein may be reproduced without express permission from the CEC.Last Site Update:3/2023. and you really want something to relief it, there are a few things you can do Cholecystectomy; Laparoscopic; Nerve block; Phrenic nerve; Shoulder pain; Ultrasonography. The upper part of the abdominal cavity was evenly and bilaterally filled with the 0.9% normal saline in the amount of 500cc we will leave the fluid in the abdominal cavity. Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number): Why Should I Register and Submit Results? Congenital defects, which happen at birth and have no known cause. You should also be aware that some pain medications may cause nausea, so make sure to notify your physician. If you have been diagnosed with a paralyzed diaphragm, you may be a . shoulder - what doctors call referred pain. We celebrate the multiple dimensions of diversity including, but not limited to, race, ethnicity, sex, gender identity, sexual orientation, socioeconomic circumstance, national origin, geographic background, ability and disability, physical characteristics, veteran status, political ideology, religious belief and/or age. 2017 Jun;39:146-151. doi: 10.1016/j.jclinane.2017.03.050. Do you have some pictures or graphics to add? They include: Do you have a great story, experience, comment or query about any thing laparoscopy or keyhole surgery? -, Minerva Chir. In fact, ISB may benefit this subset of patients. If the pain perceived in the tips of the shoulders is related to inflammation of the peritoneal reflections supplied by the phrenic nerve, this may also be reduced by anti-inflammatory analgesics. In some cases, it has been reported to last more than 72 hours after surgery. The etiology of pain after laparoscopic cholecystectomy is multifactorial (9). The significance of phrenic nerve block was studied in the anesthetic management of laparoscopic cholecystectomy. These nerves run to the shoulder, and if they are stimulated, it can cause shoulder pain. Randomized double-blind comparison of phrenic nerve infiltration and suprascapular nerve block for ipsilateral shoulder pain after thoracic surgery. (You can preview and edit on the next page), Help Keep This Site GoingDonate To Show Your Support, Return To Home Page from Shoulder Pain After Laparoscopy Page, YOUR GUIDE TO CAUSES AND TREATMENT OF ABDOMINAL PAIN, Upload 1-4 Pictures or Graphics (optional), Hi, About 18 months ago I had to call an ambulance as I had severe pain in my abdomen on the left side. After the surgery, the shoulder is likely to be sore. Pain in the right shoulder and arm is often due to muscle or tendon damage. The Minimal Access surgery course was created in a manner that after this program surgeon & gynecologist will be able to do all the taught surgery their own on their patients. Summary. It happens usually due to irritation of diaphragm while passage of bolus of food. Is this common? A pulmonary recruitment maneuver consisting five manual pulmonary inflations was performed with a maximum pressure of 60 cmH2O. World J Surg. Pinched Nerve in the Thoracic Spine Often caused by an acute injury or accident, a thoracic compressed nerve causes pain in the upper back, chest and torso. Please enable it to take advantage of the complete set of features! Therefore, the investigators should try to reduce carbon dioxide retention in the pelvic cavity. The procedure usually only takes an hour or two. A phrenic nerve is made up of axon fibers that originate in the neck and travel to the diaphragm. Goal Weight: 125 lbs. 1,2 Pain in laparoscopic abdominal surgeries is due to 3 components: somatic (port site incision), visceral (peritoneal), and phrenic nerve irritation (shoulder tip pain). Maneuvers to Decrease Laparoscopy-Induced Shoulder and Upper Abdominal Pain: A Randomized Controlled Study. Other possible etiologies of shoulder pain after thoracic surgery are the loss of one of the main bronchi, the position of the patient during surgery, tightening of musculature and the shoulder joint and thoracotomy route . 2010 Sep-Oct;35(5):455-7 The intense sharp pain in the left shoulder is caused by the damage to the phrenic nerve that can sometimes (certainly not always) happen during nissan fundoplication surgery. You may feel shy about talking about passing gas, but it is important to let your health care team know how it feels. Weight Lost: 79 lbs. During this time, pain medications should be avoided because they may cause nausea. Nerves Regulate Breathing The phrenic nerve is actually a pair of nerves, the right and left phrenic nerves, that activate contraction of the diaphragm that expands the thoracic cavity. In patients undergoing laparoscopic surgery, carbon dioxide gas that is used during the procedure may irritate the phrenic nerve. EDITOR: Shoulder pain after laparoscopic surgery has been thought to be due to the irritation of the phrenic nerve, which may be mainly caused by insufflated carbon dioxide .However, shoulder pain can be caused by stretching of the shoulder, which is constrained by many muscles and ligaments .We investigated postoperative shoulder pain in 72 patients who underwent gynaecological laparoscopy by . Intraoperative chest fluoroscopy is performed to . . This referred type of pain is a major concern for patients after laparoscopic surgery, as it can cause patient dissatisfaction and even serious complications such as pulmonary issues. Usually, this is caused by severed, stretched, or compressed nerves. This study aimed to determine the incidence and risk factors of shoulder pain after hepatectomy. How do you stop shoulder pain after surgery. Take some pain killers like Paracetamol or Tylenol. Regional anesthesia has an established role in providing perioperative analgesia for shoulder surgery . The residual CO2 causes pressure on the nerve, which in turn, causes the pain. FOIA The anesthesiologist held the fifth positive pressure inflation for approximately 5 seconds. The phrenic nerve is an important part of the diaphragm, so understanding its anatomy is important. World Laparoscopy HospitalCyber City, Gurugram, NCR Delhi INDIA : +919811416838World Laparoscopy Training InstituteBld.No: 27, DHCC, Dubai UAE : +971525857874World Laparoscopy Training Institute8320 Inv Dr, Tallahassee, Florida USA : +1 321 250 7653, Paid Online Consultation From Our Surgeon, shoulder pain, as the gas can irritate your diaphragm (the muscle you use to breathe), which in turn can irritate nerve endings in your shoulder. Another simple way to reduce the pain is to find a position that is most comfortable. However, shoulder pain can be caused by stretching of the shoulder, which is constrained by many muscles and ligaments. Gas pain can occur after abdominal surgery, and it can start in the shoulder and back. Irritation to the diaphragm may cause a person to feel pain in the shoulder area. If youre looking for information on how to relieve phrenic nerve pain following laparoscopic surgery, youve come to the right place. Additionally, hot tea can stimulate gastrointestinal motility and help you relieve painful gas pains. This will help prevent shoulder pain. After surgery i keep my patients on pured foods to allow the stomach to heal.. Read More. Background and Objectives: Ipsilateral shoulder pain (ISP) is a common complication after thoracic surgery. The pain tends to be at the tip of the shoulder. After a surgery, residual CO2 gas can irritate this nerve, causing shoulder pain and diaphragmatic pain. Usually, the pain occurs on the right side. The hypothesis of post-operative shoulder-tip pain is that carbon dioxide induced phrenic nerve irritation causes referred pain to C4. Most people recover from this procedure in a few days. It is an interesting nerve as it is actually two separate nerves on each side of the body, even though it is typically referred to as one nerve. However, one disadvantage of the procedure is that patients are more likely to experience shoulder pain. The most common symptoms of nerve damage after surgery are usually numbness, tingling, burning, muscle weakness or atrophy. However, this gas can also irritate the nerves and affect the physiology of the surrounding peritoneal tissue.It was once believed the resultant shoulder pain was simply due to reaction of the gas combining with water, or that it was merely trapped CO2. However, the actual cause of the irritation is the result of cellular death (not as formidable as it sounds - this is simply a direct response to tissue injury, considered part of the wound-healing process itself) caused by the combination of a temperature change from the gas at 70F and the drying effect of the gas at .0002%.3 Much of this irritation is centered on the diaphragmatic region. finding this helpful in overcoming their shoulder tip pain. Danelli G, Berti M, Casati A, Bobbio A, Ghisi D, Mele R, Rossini E, Fanelli G. Eur J Anaesthesiol. Unfortunately, the use of carbon dioxide (CO2) to insufflate the abdomen is the main contributor to post-operative shoulder pain. . After laparoscopy, the gas it let out, but some will certainly Evidence suggests that shoulder pain after laparoscopy mainly occurs due to the irritation of the afferent nerve fibers of the diaphragm phrenic nerve, induced by the residual CO 2 , blood, or . After laparoscopic surgery, you will be asked to remove any jewelry near your navel. In addition, you should drink lots of fluids and avoid constipation. Elevation is another helpful method. After laparoscopic surgery, it is common for patients to experience shoulder pain. Keywords: Excess fluid or blood clots trapped in the upper abdomen and between the diaphragm and right . Unable to load your collection due to an error, Unable to load your delegates due to an error. 2007 Sep; 62(9):913-8, 3., 7. Ask a doctor any question online now and get answers within minutes. However, it will subside on its own. If your shoulder pain after a minimal access surgery is due to internal Bethesda, MD 20894, Web Policies Ipsilateral shoulder pain after thoracotomy surgery: a prospective, randomized, double-blind, placebo-controlled evaluation of the efficacy of infiltrating the phrenic nerve with 0.2%wt/vol ropivacaine. 2020 May 29;13(2):45-49. eCollection 2020 May. For many, they do not CO 2 remains in the peritoneal cavity for several days after surgery and causes stretching of the phrenic nerve endings, local hypothermia, and diaphragmatic irritation via carbonic acid. The prolonged presence of shoulder tip pain suggests excitation of the phrenic nerve due to irritation of diaphragm by CO2. You can wrap a word in square brackets to make it appear bold. Try using two heating padsone on the front and one on the back of the affected shoulder. The anesthesiologist held the fifth positive pressure inflation for approximately 5 seconds. We would love to hear from you. notice this pain in the first day, but it develops gradually and become severe The Phrenic Nerve Program is a collaboration between Reza Jarrahy, MD at the UCLA Division of Plastic & Reconstructive Surgery and Matthew Kaufman, MD at the Institute for Advanced Reconstruction. Insuflow confers improved pain control and reduces the need for opioids and antiemetics in the postoperative period by humidifying and warming the CO2 to 95F and 95% relative humidity. Shoulder pain is a common side effect after laparoscopic surgery. Severe ISP can cause ineffective breathing and impair shoulder mobilization. 1996 Nov;77(5):576-80 Although most patients report minimal pain after laparoscopic surgery, about 35 to 70% of patients complain of shoulder pain. Method: You can also try rocking your knees from side to side. I freedive because there is no other place that I can go to where I feel so out of and in control at the same time. Your doctor may use dissolvable stitches to close the incisions. . The pain is then referred upward through the nerves until it lands in the shoulder. The phrenic nerve is a mixed nerve arising from the anterior rami of C3-C5 spinal nerves, which are components of the cervical plexus.It arises in the neck and descends vertically through the thorax to end on the diaphragm.The phrenic nerve is a bilateral nerve, and its left and right counterparts have some important differences in terms of course and relations with surrounding structures. Shoulder pain is a common side effect after laparoscopic surgery. Laparoscopic surgery and shoulder pain ; Surgery for adhesions ; Cholecystectomy: A procedure for abdominal pain ; Surgery for ovarian cysts . To minimize the pain, they can elevate their head with pillows and avoid lying flat on their back. The phrenic nerve is a nerve that originates in the neck and goes down to the diaphragm. Do you have some pictures or graphics to add? The right phrenic nerve runs superficial to the anterior . . Rarely, shoulder pain after laparoscopy could be due to internal This clinical controlled trial is tried to find out the practical and clinical maneuver to reduce post-operative should-tip pain following laparoscopic surgery. Current Weight: 189 lbs. var months=new Array(13);months[1]="January";months[2]="February";months[3]="March";months[4]="April";months[5]="May";months[6]="June";months[7]="July";months[8]="August";months[9]="September";months[10]="October";months[11]="November";months[12]="December";var time=new Date();var lmonth=months[time.getMonth()+1];var date=time.getDate();var year=time.getYear();if(year<2000)year=year+1900;document.write(""+lmonth+" ");document.write(date+", "+year+""); Shoulder pain after laparoscopy is very common. Also, remember to drink lots of fluids and avoid constipation. 2006 Nov;30(11):1969-73. doi: 10.1007/s00268-005-0752-z. Share it! How do I get rid of gas pain in my shoulder? This review presents an overview of the currently evaluated techniques to reduce . This pain can last several days. If youre able, try to listen to music during your procedure. Heat packs and moving around should help to relieve the pain. A laparoscopic procedure leaves a residual amount of gas in the abdomen. [2] Flying after laparoscopic surgery. intermittent ureteropelvic junction obstruction and antenatal hydronephrosis is scheduled for right robotic assisted laparoscopic pyeloplasty. With each dive I feel like I meet my Maker. Its a type of nerve pain that feels like pins and needles. All the nerve branches are no closer than 1.5 cm me-dial to these land-marks for all positions of humeral rotation with the arm at the side. Let's review the causes and treatment of this annoying pain after undergoing a keyhole or laparoscopic surgery as well as what can be done to reduce such pain. This gas can irritate the diaphragm and the phrenic nerve, which has nerve endings in the shoulder. You may also be prescribed anti-inflammatory medication. I was discharged and they told me it was an intercostal, Mesenteric lymphadenitis is a common cause of right-sided abdominal pain in children, that mimics appendicitis. lost a significant amount of blood, filling the whole of the abdominal cavity, To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. The phrenic nerve is important for breathing and has both sensory and motor functions. Some clinical trial studies determined that Pulmonary Recruitment Maneuvers and Intraperitoneal Normal Saline Infusions (INSI) reduced shoulder pain; with INSI proving a superior method.5 Preemptive analgesia is also helpful. It provides support and reminds patients not to move their arm. Pain after laparoscopic surgery can be divided into: There is marked interindividual variability of post-operative shoulder-tip pain following laparoscopic surgery. described above. Why Does your shoulder hurt after a laparoscopy? Dr. Prashant Sinha answered. This inflammation can lead to sharp, achy pain. internal bleeding, speak to your doctor immediately. If you experience these, try gently massaging your tummy to release trapped gas. Taking a rest is also recommended. The phrenic nerve is a bilateral, mixed nerve that originates from the cervical nerves in the neck and descends through the thorax to innervate the diaphragm. Once you are fully awake, youll receive post-operative instructions, including how to keep the wounds clean and when to come for follow-ups. There is a high incidence of shoulder pain after visceral surgical procedures. The incidence of such pain varies from 35%-83% across patient populations, ranging from mild to severe, and in some cases, the pain has been reported to last even longer than 72 hours post-operatively (though this is less common).1 Moreover, in nearly 70% of cases studied, patients experienced the worst pain not immediately post-operatively - but up to 24 hours aftertheir surgery.2 Read on to find out why this occurs - and what we have been doing for years at our Center to help effectively reduce and diminish this pain in our own patients.To begin, during Laparoscopy,CO2 (carbon dioxide) gasis injected through a special needle inserted just below your navel.