Diving After Surgery and Injury – What Divers Need to Know
Returning to scuba diving after surgery or injury is one of the most common and most misunderstood questions in dive medicine. Whether the issue is abdominal surgery affecting pressure tolerance, or orthopaedic repair that challenges strength, mobility, and circulation, the central concern is the same: can the diver safely manage pressure, exertion, and emergencies underwater? The following two questions explore these issues from different angles, gastrointestinal surgery and bone fracture, but both hinge on recovery timelines, physiological stress, and the risks of returning too soon.
Diving Following a Nissen Fundoplication
Q: I am a 57-year-old male who is planning to undergo a laparoscopic Nissen fundoplication for refractory gastroesophageal reflux disease (GERD) and a hiatal hernia. Is the procedure considered an absolute or relative contraindication to recreational diving? How crucial is the ability to belch after a Nissen fundoplication?
A: The decision to resume scuba diving following a Nissen fundoplication is intricate and personalised. Hiatal hernias can present a dive risk due to potential air trapping and gastric rupture. Even after surgical repair, there’s a possibility of gas bloat syndrome featuring gastric distention and the inability to belch, which could complicate dive situations.
Why Gas Expansion Matters in Post-Surgical Diving
The surgical team should assess the risks of air trapping and reflux. Discussing your specific case with your surgeon, accounting for the surgical technique, your medical history, and the physical gas laws associated with diving is imperative. Even when cleared by your surgeon, DAN advises caution until you have established your ability to dive safely, particularly in the initial post-surgery phase.
While some individuals successfully return to diving after Nissen fundoplication, some have complications. A safe return to diving should involve consulting your treating physician and considering physical therapy, rehabilitation, and medication requirements. Waiting an additional half of the recovery time your physician recommends before resuming diving allows a sufficient duration for tissue and vasculature recovery.
Diving After a Fracture and Orthopaedic Repair
Q: I suffered a hip fracture and three weeks ago had surgery to insert a plate and screws on the neck of my femur. Is it safe to dive eight weeks after surgery, and is there a risk of decompression illness (DCI)?
A: While you should seek a specific answer from a local physician trained in dive medicine, I can offer general guidelines. The industry standard for a return to diving after any fracture is for your doctor to release you for full and unrestricted activity, including contact sports, and then have an additional convalescent period of one-half the length of the regular healing time for the fracture.
Fitness, Healing and Decompression Illness Risk
This extra time is to recover any lost physical fitness and aerobic capacity due to atrophy during the healing and rehabilitation process. If your doctor releases you for full and unrestricted activity after six weeks, for example, you should add three weeks for a total waiting period of nine weeks. These numbers are merely an example, and you should consult with your treating physician for a definitive answer.
The ability to conduct rigorous exercise, stress that joint through the range expected, and have a full recovery without restrictions, risk of injury, dislocation or other problems are issues to discuss with your surgeon. n
For an extensive range of diving health and safety information and downloadable resources, research studies, incident summaries, and free e-Learning courses, take the time to explore the DAN website.
Frequently Asked Questions
Can you scuba dive after a Nissen fundoplication?
Diving after a Nissen fundoplication is possible for some individuals, but it requires careful medical assessment due to risks of gas bloat syndrome and air trapping.
Why is the ability to belch important after fundoplication surgery?
Inability to belch can cause gastric gas expansion, which may become problematic during ascent and pressure changes while diving.
How long should you wait before diving after abdominal surgery?
Divers should wait until fully healed, cleared by their surgeon, and often add additional recovery time to ensure tissue and vascular healing.
Is scuba diving safe after a fracture with plates or screws?
Diving is generally considered only after full unrestricted activity is permitted and additional convalescence restores strength and fitness.
Does surgery increase the risk of decompression illness (DCI)?
Reduced fitness, inflammation, and impaired circulation during recovery may increase DCI risk if diving resumes too early.
Who should clear a diver to return to diving after injury?
A physician trained in dive medicine, in consultation with the treating surgeon, should make the final determination.
This article was originally published in Scuba Diver Magazine
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