Comprehensive information about diving and undersea medicine for the non-medical diver, the non-diving physician and the specialist.
A. Consider the illness or condition being operated upon and any relationship to the diving environment
B. Consider the physical limitations imposed as a result of the operation
Rate of wound healing of the specific body system
Complications (infection, wound disruption, temporary loss of function)
Disability from any source reducing the diver's functional ability.
C. Implants of any nature
Any implant that does not contain air or gas should not be a contraindication to diving. This includes all metallic, silicone, composite and fluid filled sacs. These objects are not compressible and therefore pose no danger to the diver. Any air or gas filled implant, such as an artificial eye or any other reconstructive body part is at hazard to explode or rupture due to the action of Boyle's Law.
D. Return to diving after surgery (See this web site under specific body system)
Link includes 'Brain, shunt surgery, herniated disc'
Link includes 'Diving after Eye Surgery', 'Post-surgical Waiting Period'
Absolute post-operative contraindications
than myringoplasty (Type I)
History of stapedectomy [This is being debated at this time].
Most recently there have been good studies to show that stapedectomy is not the risk that
was once thought.
See this article:
Otolaryngol Head Neck Surg 2001 Oct;125(4):356-60
Diving after stapedectomy: clinical experience and recommendations.
House JW, Toh EH, Perez A.
Clinical Studies Department, House Ear Clinic and Institute, 2100 West Third
Street, Los Angeles, CA 90057, USA.
CONCLUSIONS: Stapedectomy does not appear to increase the risk of inner ear
barotrauma in scuba and sky divers. These activities may be pursued with
relative safety after stapes surgery, provided adequate eustachian tube
function has been established.
inner ear surgery
Status post laryngectomy or partial laryngectomy
Radical mastoidectomy (posterior) involving the external canal is
disqualifying. (Closed childhood OK)
Incompetent larynx due to surgery (Cannot close for valsalva
Cardiac and valvular surgery
entering the chest cavity; six to eight weeks or whenever the
physically rehabilitated to reach 13 METS on the treadmill.
Surgery with entry into the chest for whatever reason; see thoracotomy.
Patent Foramen Ovale -
closure (Amplatzer) is performed trans venously without
chest. Four weeks after the
surgery, another echocardiogram is done to verify that the
still in position. After
two-three weeks there is an
endothelial cells covering the device, reducing the risk of
six to eight weeks the connective
tissue has completely filled
the spaces in the device and it becomes invisible to
to diving is usually in six weeks (Wilmshurst), given the
satisfaction of the cardiologist/surgeon. Others require a
of twelve weeks.
See article by Wilmshurst, et al at http://heart.bmjjournals.com/cgi/content/full/81/3/257
with a thoracotomy can be certified for diving after
by a thoracic surgeon knowledgeable of diving medicine. Post
wait of 12 weeks; surgical release recommended. Should be
out air trapping.
Lobectomy or pneumonectomy patients usually fill in the 'dead space' from the loss of tissue with fluid and scar. Depending on the cause of the surgery, postoperative course and results of pulmonary function and scans a person might be allowed to return to diving with the approval of their physician.
Divers with pulmonary
barotrauma may return to diving after no less than a
and a certification from a diving physician that there is no
A history of bowel obstruction is not disqualifying if the person is asymptomatic 3 months after corrective surgery. Wait six to 12 weeks postoperative before diving. Surgeon's advice recommended.
The postoperative wait after laparotomy depends greatly upon the cause for the surgery and the extent of surgery involved. A postoperative wait of six to twelve weeks is recommended, again with the approval of the diver's surgeon. Continent urostomy or ileostomy contraindicates diving because of Boyle's law.
A hernia that includes bowel is disqualifying until surgically repaired. A wait of 6 weeks is suggested for the simple repair. Advice of surgeon suggested.
Bone & Joint
Prostheses, joint surgery, fractures
diving is entirely dependent on evidence of complete healing.
Weight-bearing with 100 plus pounds of gear, exits and entries
carefully considered by the surgeon before certifying return
The effects of pressure and bubbling on the operative site are
at this time.
General Advice About Diving
Whether or not a person
surgery should be certified as 'fit to dive' should be decided
of each case, the type of surgery required, if symtomatic or
and the length of time postoperative free of problems. Most
return to diving. Decision making ability, ability to self
other divers residual disabilities that would limit ability to
and move in the water should be taken into consideration.
should in all cases provide full disclosure to the dive
certifying agency - bearing in mind the safety of buddies,
divemasters and other individuals who are always affected by
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