LAPAROSCOPY

WHAT IS A LAPAROSCOPY?

This involves putting a telescope measuring 5 or 10 mm in diameter through the umbilicus into the tummy. This helps us to visualise the reproductive organs (uterus, tubes, ovaries and the rest of the pelvis and abdomen) on the screen.

ADVANCED LAPAROSCOPIC SURGERY INCLUDES :
  • Laparoscopic Myomectomy (removal of fibroids)
  • Laparoscopic Adhesiolysis
  • Laparoscopic Ovarian drilling (treatment for PCOD)
  • Laparoscopic Ovarian cystectomy (removal of fluid filled sac from the ovary)
  • Laparoscopic Excision of endometriosis , including chocolate cysts
  • Laparoscopic Salpingectomy (removal of tube)
  • Laparoscopic Salpingolysis (Tubal fertility surgery)
  • Laparoscopic Tubal recanalisation (rejoining the tube)
  • Laparoscopic Hysterectomy (removal of the womb)

These are general instructions applicable to most patients undergoing a laparoscopy. According to individual situation, doctors will advise you personally.

Preoperative information


Preoperative fitness check would be done when the date of the operation is decided Preop investigations are necessary to establish fitness for surgery.

Instructions before admission to hospital

If your operation is scheduled for the morning, it is important that you do not eat or drink from midnight onwards. If your operation is in the afternoon, you may have a light, early breakfast and then fast for atleast six hours.

What to bring along when getting admitted

Please keep all your jewelery and valuables at home before coming to the hospital. The hospital or any staff cannot be held responsible for any loss of such personal property.
Please bring your personal clothes and items of your own use
If you have to stay overnight in the hospital, you will be given toothbrush, toothpaste, soap, comb, hand towel and bath towel.
All bedding needed for your use will be provided
Please keep a pillow cover, bed sheet and a shawl for your relative to use
For those going home on the same day, soap and a hand towel will be given

ON THE DAY OF OPERATION

On the date and time planned, please come to the Endoscopy Suite on the second floor. You are requested to be seated in the waiting area till one of the staff members attend to you.

WHAT TO EXPECT NEXT ?

Once you have been admitted, please change into the theater gown provided. You will be seen by an anaesthetist after admission.
A needle is put into the arm through which the anesthetic drugs are given to put you to sleep.

GOING TO THE THEATRE

On most occasions you will be able to walk to the theatre. There will be few members of staff in theatre pyjama suites (dress) wearing caps and masks. They are all present to help. You will then be asleep while the laparoscopy is done. You may wake up when you return to the ward and not remember the operation at all.

POSTOPERATIVE INFORMATION

When the operation is over, you will be wheeled to your bed. You will be sleepy and drowsy due to the anaesthetic drugs for few hours after the operation. You may feel sick and sometimes may vomit. It is important that you take oral intake only when advised by the staff.
You can go to the toilet, but make sure that someone is present to help. Once you can tolerate the oral intake, empty your bladder and are able to walk around on your own, you could go home.

POSTOPERATIVE INFORMATION

WHAT ARE THE POSSIBLE COMPLICATIONS ?
Laparoscopy is a very commonly performed operation.
The possible complications include:
Bowel injury
Bladder injury
Vessel injury
Possibility of Laparotomy
These are very rare complications with an incidence of less than 1 in 1000 patients.

HOW MUCH REST DO I NEED ?

During the first 24 hours you need a lot of rest to recover from the operation. On the day after the operation, your recovery will get faster. On most occasions, within 48 hours, you would be able to eat and drink as usual, you can walk around comfortably and you are able to look after yourself very well. After 48 hours, you should expect to continuously get better and better. If your pain is getting worse or temperature is felt, then please contact the hospital. Sometimes, it takes longer (upto 10 days for the pain to disappear). Generally this happens after operative laparoscopy as body needs more time to heal.

INSTRUCTIONS AFTER DISCHARGE

It is important to avoid putting pressure on your tummy within the first 72 hours. Avoid lifting heavy weights, avoid walking up the stairs, and avoid standing for too long.. There are no specific restrictions on your diet after going home. It is advisable to eat easily digestible diet.
On most occasions dissolvable stitches are taken that do not need removal. The small wounds need dressing for three to four days after which Band-Aids can be applied You can have bath after the first 72 hours, but please keep the wounds covered and dry immediately after bath

WHEN CAN I GO TO WORK ?

It is advisable to stay away from work for atleast the 48 hours. A maximum period of seven days is required. Most people resume work after the first 48 to 72 hours.

LAPAROSCOPY DETAILS FOR LARGE FIBROIDS


Laparoscopy is done with the help of four small cuts (5mmx3 and 10mm x1) after putting you to sleep. Your fibroids are of significant size. There is a 95% chance of removal with the key hole surgery. In 5% of cases like you, there is a possibility of open surgery (8-10cm cut on the tummy) this is very unlikely, but mentally you need to be ready for that. In case of blood loss, there is a very small chance of (less than 1%), that you may need blood transfusion. In order to decrease these risk further, we can give you two injections (one per month) that will help to shrink the fibroid and decrease its blood supply. These are not necessary with small fibroids, but in your case the injections will help. The name of injection is Zoladex.
The cuts are made on the lower part of the tummy and one is inside the naval. The above procedure is done by putting a fine telescope (5mm size) through your naval. This is why it is called endoscopy. It is very safe and the risk of complications (injury to bladder, bowel and vessel is less than one in thousand). Your fibroids are large and multiple, hence we will need to double the risk. Please be prepared for 3 days stay in hospital and keep extra couple of days available. The discomfort in the couple of weeks after the operation will be felt, but bearable. The full recovery to complete normality will need a month. You can return home in a week time after the surgery.

GENERAL INFORMATION :


Visiting hours: 10am to 1pm and 6pm to 9pm

  • Main hospital gate would be locked at 10pm for security reasons
  • At other times, for surgical patients – only one relative can stay with the patient
  • While shifting the patient from OT to the room, the relative is requested to wait at the front reception
  • Tea/Coffee would be offered to patients twice a day. Relatives can purchase tea/coffee from the vending machine for Rs5/-
  • Lunch and Dinner are not provided by the hospital, but contact numbers of nearby caterers can be given. You have to make that arrangement on your own responsibility.
  • Bed linen (Pillow and bed sheets) will be changed every day and rooms will be cleaned regularly
  • Hospital policies are displayed near each bed and all are requested to abide by them by order
  • Any suggestions or complaints should be forwarded to the management through the reception so that corrective measures can be undertaken.