The traditional operation involves cutting open your abdomen to replace the aneurysm with an artificial piece of artery (a graft). This is a major operation and carries some risk. However, it is successful in most cases and the long term outlook is good. The graft usually works well for the rest of your life.
Recovery and aftercare
Typically, you will spend 1-2 days in the intensive care unit or high dependency department after your surgery so that your progress can be closely monitored.
You will usually need to stay on a breathing apparatus for a short time after surgery, but you will be removed from it as soon as possible.
After this type of surgery, the bowel will stop working for a while and you will be given all the fluids you need in one drop until your bowels can handle fluids by mouth.
A blood transfusion may need to be performed. Some hospitals will recycle your own blood that was lost during the surgery and give it back to you.
The nurses and doctors will try to keep you pain-free by giving pain relievers by injection, through the epidural tube in your back, or through a machine that you can control yourself at the push of a button.
Over the next few days as you begin to recover, the various tubes will be removed and you will return to the normal ward until you are fit enough to go home (usually 8-10 days after surgery).
You will be given a small injection every day to reduce the chance of deep vein thrombosis (DVT) or pulmonary embolism (PE) after surgery. These will continue until you are fully mobile and released from the hospital.
Go home and follow-up care
If your stitches or clips need to be removed, it is usually done while you are still in the hospital. If not, your GP or district nurse’s office will have it removed and inspected your wound.
Exercise: Regular exercise is recommended for the first few weeks, e.g. B. A short walk combined with rest, followed by a gradual return to normal activity.
Driving: You can drive if you can safely perform an emergency stop. This is usually 3-4 weeks after surgery, but if in doubt, consult your own doctor. You should let your insurer know that you’ve had major surgery.
Bathing: As soon as your wound is dry, you can bathe or shower as usual. This usually happens before you leave the hospital.
Work: If this applies to you, you should be able to return to work within 6-12 weeks of the operation. Your GP will let you know when you see him / her about your medical record.
Lifting: You should avoid heavy lifting or overexertion for 6 weeks after surgery.
Medicines: You will usually be sent home with a small dose of aspirin and a statin if you haven’t already taken them. This makes the blood less sticky and lowers your cholesterol levels. If you’re allergic to aspirin or if it bothers your stomach, an alternative medication may be prescribed.
As with any major surgery, there is a small risk of medical complications such as:
- Heart attack
- Kidney failure
- Breast problem
- Loss of circulation in the legs or intestines
- Infection in the artificial artery
Each of these are rare, but overall it means that some patients may not survive their surgery or the immediate postoperative period.
For most patients, this risk is around 7% after open aneurysm repair – in other words, 93 out of 100 patients will fully recover from surgery.
The doctors and nurses will try to prevent these complications and treat them quickly if they arise. Surgeons at your hospital can provide you with the local death rate for this surgery.
If your risk of a serious complication is higher, usually because you already have a serious medical problem, your surgeon will discuss this with you. It is important to remember that your surgeon will only recommend treating your aneurysm if he or she believes that the risk of aneurysm rupture is much higher than the threat from the surgery.
DVT / PE: After any major surgery, there is a risk of DVT (deep vein thrombosis) or PE (pulmonary embolism). You will be taking medication to reduce the risk, but this cannot be completely negated. If you are given DVT or PE, you will need a tablet period (warfarin) to thin the blood for 3 to 6 months.
Breast infections: These can happen after this type of surgery, especially in smokers, and may require treatment with antibiotics and physical therapy.
Wound infection: wounds sometimes become infected and may need antibiotic treatment. Serious infections are rare. Occasionally the incision needs to be cleaned under anesthesia.
Graft infection: Very rarely (about 1 in 500) the Dacron graft can become infected. This is a serious complication and treatment usually involves removing the graft.
Fluid leakage from the wound: Occasionally, the wound in your groin may fill with a fluid called lymph that can leak out between the stitches. This usually calms down over time.
Bowel problems: Occasionally, the bowel starts to work slowly after the operation. This requires patience and fluids are provided in a drop until your bowel returns to normal.
Sexual activity (impotence): This can happen in men because the nerves in your abdomen are inevitably injured during surgery. This occurs in around 10% of patients.
What can i do to help myself?
If you are a smoker, make determined efforts to quit completely. Further smoking will further damage your arteries and increase the risk of heart attacks, strokes, and circulation problems in your legs.
General health measures like weight loss, low fat diet, and regular exercise are also important.