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Complex Laparoscopic Treatment

What are complex treatments?

These include operative procedures for adhesions, endometriosis, ovarian cysts, fibroids and hysterectomy.

How is it done?

Once you are asleep under a general anaesthetic a cut is made under in your belly button as well as 2 – 4 other cuts (incisions) in your abdomen depending on the site and complexity of the surgery. Several other instruments are passed in through these incisions to move, or operate on your organs.

The laparoscope is passed into your abdomen. Gas is used to lift the body wall off the internal organs so the surgeon has a good view inside. Another instrument will be passed through the vagina into the cervix to lift the womb (uterus) and help the surgeon to see everything. The operation will take anywhere from one hour to three hours.

Before the operation

Patients usually come into hospital on the day of the operation. You must not eat anything for six hours before your operation so there is no danger of vomiting while you are asleep. You will have been advised on bowel preparation and been given a prescription to take some medication for this if required. Though not the most pleasant thing to do, please follow these instructions diligently.

What about after the operation?

  • You will wake up in the recovery room next to the theatres and will be taken back to the ward within a couple of hours. Your blood pressure, temperature and other observations will be made.
  • You are likely to feel sick for a while after the anaesthetic. Most women feel wind-like pain in the abdomen or shoulders: it passes off within 48 hours. If you do feel sick we can give you anti-sickness medication.
  • You will be reviewed soon after your operation and you will be given an explanation of what was found and done. You will be advised on when you can eat following the operation. You will also be advised on the length of stay in hospital which could vary and last a few days.
  • The stitches used are usually dissolvable and do not require removal, however can be removed after a week if they cause irritation of the skin.
  • You will probably want a few days’ rest before returning to work, but you can return to all activities when you feel ready. Usually we advise a week or two off work.

What are the risks?

Excision or treatment of significant disease can result in complications. These include:

  • Blood vessels can be damaged causing significant bleeding and perhaps needing a blood transfusion.
  • There is a risk of damage to the bowel, bladder, ureter or other pelvic and abdominal organs. Such damage can often be repaired by keyhole surgery but on occasions require your abdomen to be opened through a much larger incision. In cases where endometriosis involves the bowel, a colostomy may be required.
  • Scar tissue otherwise known as adhesions can occur after such surgery
  • Rarely, a hernia develops under the scar many weeks or months after the operation.

What happens post operatively?

After your surgery it is usual to feel uncomfortable for a few days. This discomfort should settle gradually and you should feel progressively better as the days pass. If you find that after several days even when discharged home you stop getting better and start to feel ill with symptoms such as nausea, sickness, a temperature and tummy pain, then you should phone the contact number to discuss your symptoms.

Do I need a check up afterwards?

If you have had keyhole surgery and become unwell within a few days of the operation, contact the ward or contact number given directly.

A follow up check may be arranged as appropriate within a week or two of being discharged and/ or within a couple of months.