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Laparoscopy: information for patients

A gynaecological laparoscopy is an examination of your pelvic organs (e.g. fallopian tubes, ovaries, womb and bowel) using a telescope called a laparoscope. When used in women with fertility problems, the tubes are checked with with blue dye, known as a laparoscopy and dye test.

The instrument is inserted through small cuts on your abdomen and can help identify and correct factors that might be affecting your fertility.

Laparoscopy can also be used to perform most operations, such as repairing damaged tubes, removal of ovarian cysts, treatment for endometriosis, ectopic pregnancy, removal of fibroids, adhesions and hysterectomy.

Laparoscopy treatment is normally carried out as a day-case procedure, requiring no overnight stay, and is usually performed under general anaesthesia. This means you will be asleep during the procedure.

We will explain the benefits and risks of having a gynaecological laparoscopy investigation, and will also discuss the alternatives to the procedure.

Mr Akande will advise on what special precautions should be taken if you fall pregnant.

About the operation

Your surgeon will make one or two small cuts on the skin, above, or just below, your belly button (navel). Carbon dioxide gas is pumped into the abdomen. This creates more room for your surgeon to work in and makes it easier to see the internal organs.

The laparoscope is then inserted into the cut. The internal organs are examined by looking directly through the laparoscope, or at pictures it sends to a video screen. Another instrument is inserted through a second cut. This instrument is used to move internal structures to see around them.

If any laparoscopy treatment or surgery is performed (operative laparoscopy), additional small cuts are made in order to insert the necessary instruments.

Afterwards, the instruments are removed and the gas is allowed to escape through the laparoscope. The skin cuts are closed with two or three dissolvable stitches.  A laparoscopic procedure can last from 30 minutes to several hours, depending on what needs to be done.

After the procedure, you are likely to feel some pain in the abdomen as well as “referred pain” in the tips of your shoulders – caused by the gas used to inflate the abdomen. This usually disappears within 48 hours or so. You may have some abdominal bruising, which usually settles without treatment.

Gynaecological laparoscopy is commonly performed and generally safe. For most women, the benefits in terms of improved symptoms, or from having a clear diagnosis, are much greater than any disadvantages. However, all surgery carries an element of risk.

Specific complications of laparoscopy are uncommon but can include accidental damage to other organs in the abdomen (such as the bowel, bladder or major blood vessels) requiring further surgery to repair the damage.

Occasionally a laparoscopy is not completed successfully and may need to be repeated. The chance of complications depends on the exact type of operation you are having and other factors such as your general health. Ask your surgeon to explain in more detail how any risks apply to you.

Laparoscopic Myomectomy – Key Hole Fibroid surgery

What is myomectomy

Myomectomy simply means having fibroids removed. Fibroids are bundles of muscle fibres that grow in the womb. They are almost always benign (non-cancerous). Fibroids increase the size of the womb. Some women have only single fibroid others could have many which could vary in size from 1cm and rarely are over 20cm. Myomectomy is generally performed in women who wish to preserve or improve their fertility.

How is laparoscopic myomectomy performed

The operation is performed with you asleep (anaesthesia) and involves passing 3 or 4 small instruments into the abdomen through small (key hole) incisions each around 1-2cm long. The operation usually takes between 1 – 4 hours depending on how many fibroids are being removed and where in the womb they are. All stitches are disolvable

Why have a laparoscopic myomectomy

There are several advantages, which include: a shorter hospital stay, quicker recovery, less pain after the operation, smaller scars on the skin and less blood loss.

Hospital admission for Fibroid surgery

On the day of your operation a nurse, Mr Akande and an anaesthetist will see you. You will give you information about your operation and ensure you are fit for surgery.

After the operation

When you awake you will have a drip with clear fluid running into your arm. Within a few hours, this drip will be removed and you will be able to eat and drink again.

Recovery after Fibroid surgery

You will usually be discharged home the day after your surgery. It is usual to be able to get back to normal activities within a week and work within 2 weeks.

Feedback from patient following Fibroid surgery

I have had considerable problems with a fibroid which had grown quite large over the last five years. The fibroid affected my fertility, resulting in three miscarriages. It caused me pain, discomfort and limited my physical activity due to the pressure it placed on my bladder.

I had seen several surgeons, prior to seeking out Mr Akande, none of which had offered me keyhole surgery. I was quite fearful of their proposed solution of three months hormonal treatment and an open myomectomy, with the accompanying side effects, risks and recovery period. I met with Mr Valentine Akande without much hope that he would propose a laparoscopic myomectomy (due to the size of my fibroid), but with a strong sense that he was a very skilled and dedicated surgeon. My confidence in him was inspired by the information I was able to find online regarding his speciality, qualifications and publications, and even a video of an operation, very similar to the one I knew I required, that he had previously conducted.

In my initial meeting with Mr Akande, it would be true to say, I was still very nervous of the various treatments available for my fibroid, but Mr Akande has a reassuring and straight forward manner and we were able to discuss my fears and preferences, regarding treatment, fully. Mr Akande then surprised and delighted me by proposing he remove this rather large fibroid via laparoscopic myomectomy and without the use of the hormone treatment I wished to avoid.

I was given all the information and time I needed to weigh up the risks and benefits of the proposed surgery, and when I decided to go ahead I was able to fix a date for surgery there and then, just four weeks away.

I was nervous on the morning of my admission, but I was prepared for surgery just an hour after arrival. Mr Akande and his team were all very calming and before I knew it, I was in recovery to discover that everything had gone well. Despite the fibroid proving to be larger than expected and surgery taking not three hours but four, Mr Akande had persevered with the keyhole surgery to give me the best outcome and shortest recovery time.

My scars are very small and neat, there have been no complications of any sort, and I was up and about right on schedule. In summary, I couldn’t be more pleased! I even have the option of more children open to me now. I only wish I had met Mr Akande several years ago and had the surgery all the sooner.

I would like to recommend him as skilled laparoscopic surgeon who takes great pride in the work he does, and who will go the extra mile when he meets a challenge. He also has a pleasant manner and great communication skills and this can really help to smooth the way if you are, like me, a nervous patient.

I am very grateful to Mr Akande, and I am so glad I put my faith in him.

Lara Perilli