Laparoscopic Gynecological Surgery Patient Information (FAQs)

Frequently Asked Questions of Gynecological Laparoscopy
This is usually individualized based on the type of gynecological laparoscopic surgery and the patient. Most ladies require pain medication for one week following laparoscopic surgery. It may be advised to avoid intercourse, tub baths, douching, strenuous exercise or heavy lifting for 4-6 weeks. Many patients choose to return to work at two weeks, provided their job is not physically strenuous. 
After most types of gynecologic laparoscopic surgery, you should not put anything in your vagina until the tissues are completely healed. Otherwise, you may develop an infection or interfere with healing. This includes tampons, douches, fingers, penis and all types of sexual activity that involve the vagina.
Constipation is common after gynecological laparoscopic surgery and usually resolves with time and/or treatment. Constipation means that you do not have a bowel movement regularly or that stools are hard or difficult to pass. Constipation can be made worse by narcotic pain medications.

If you are having vomiting in addition to constipation, or if your laparoscopic surgery involving the intestines, call your gynecologist before using medications to treat constipation.

A common approach to constipation after gynecological laparoscopic surgery is to take a laxative eg, magnesium hydroxide or fiber supplement or methylcellulose, this can be taken with a stool softener.
If you have had gynecological laparoscopic surgery, you may feel a pulling sensation during urination or you may feel sore if the urine falls on vaginal stitches. It can be normal to urinate frequently after laparoscopic gyne surgery. Call your surgeon if you have any of the following:
  1. Burning with urination
  2. Needing to urinate frequently or urgently and then urinating only a few drops
  3. Temperature greater than 101ºF or 38ºC 
  4. Pain on one side of your upper back that continues for more than one hour or keeps coming back
  5. Blood in your urine 
Women are more likely to develop endometriosis if a close female relative from their parent's side has endometriosis. Likewise, if you have been diagnosed with endometriosis, and someone in your family has painful periods and pelvic pain at other times during her menstrual cycle that interfere with school and social activities, it is a good idea to suggest that they get evaluated by a gynecologist. 
The smaller incisions are less painful. As a result, we see a decreased need for pain medication, shorter recovery time and better cosmetic result. Patients are able to eat when they feel ready, and there is less internal scarring, less hernia, less chance of infection and early return to work.
Almost all the Gynecological procedures which were in the past was performed by open surgery now can be performed by Laparoscopic Surgery. Most common gynecological laparoscopic procedures are:
  • Diagnostic Laparoscopy and Laparoscopic Sterilization
  • Laparoscopic Management of Ovarian Cyst
  • Laparoscopic Salpingo-Oophorectomy
  • Laparoscopic Management of Tubal Pregnancy
  • Laparoscopic Assisted Vaginal Hysterectomy
  • Laparoscopic Total Hysterectomy
  • Supracervical Laparoscopic Hysterectomy
  • Laparoscopic Re-canalization Surgery
  • Diagnostic Hysteroscopy
  • Laparoscopic Burch Suspension
  • Laparoscopic Myomectomy
  • Laparoscopic Intestinal and Tubal Anastomosis
  • Laparoscopic Sacro-Colpopexy
  • Radical Laparoscopic Hysterectomy
  • Laparoscopic Pelvic Floor Repair
  • TVT and TOT & TVTO for Stress Urinary Incontinence
  • Laparoscopic Vesico-Vaginal Fistula Repair
  • Laparoscopic Lymphadenectomy for Gynecological Malignancies
  • Laparoscopic uterine nerve ablation (LUNA) for chronic pelvic pain
  • Laparoscopic Recanalization Surgery
  • Laparoscopic Fimbrioplasty
  • Laparoscopic Presacral Neurectomy
  • Laparoscopic Management of Severe Endometriosis
The risks are similar for laparoscopic gynecological surgery as of open and vaginal surgery. There is always a possibility that the laparoscopic surgeon cannot complete the procedure laparoscopically and a larger incision may be needed. This risk is small, as are the risks of bleeding, infection, damage to the bladder, bowel, blood vessels, and ureters. With any gynecological surgery, there may be unforeseen risks and potential, but exceedingly rare risk of death.
You may eat and drink normally a few hours after gynecologic laparoscopic surgery. You may have a decreased appetite for the first few days after gynecological laparoscopic surgery; eating small, frequent meals or bland, soft foods may help. However, if you are not able to eat or drink anything or if vomiting develops, call your surgeon as it may be a sign of complication.
The day of your Gynecological Laparoscopic Surgery you will be asked to arrive early where you will meet members of our nursing and anesthesia staff. They will start your IV, and along with your laparoscopic surgeon, review the planned procedure and obtain your consent.

During surgery, pneumatic stockings are used to massage your legs and prevent blood clots originating from calf muscles vein. Depending on the gynecological procedure you are having, you may receive antibiotics to prevent infection or have a catheter placed after you are asleep.

Some women find it helpful to avoid uncomfortable positions or activities, support their abdomen with a folded blanket or pillow, or to hold a hot water bottle over the painful area (close the bottle tightly and cover with a towel to avoid burns).

You can take pain medications as needed, or, if you have pain that is constant and moderate to severe, it is helpful to take the medication on a schedule, as prescribed (usually every four to six hours). This will help to prevent severe pain from coming back between doses.

It is not necessary to take pain medication if there is little or no pain. If you do need pain medication, take it as directed on the prescription bottle. Taking pain medications at higher doses or more often than prescribed can be dangerous.
Generally, you may experience any of these symptoms just after gynecological laparoscopic surgery:
  1. Nausea
  2. Scratchy throat, if a breathing tube was placed
  3. Uterine cramping
  4. Shoulder pain from the gas used to see during laparoscopy
  5. Feeling bloated or gassy
  6. Vaginal bleeding or discharge (like a menses)
Some light vaginal spotting or bleeding is expected and may continue for several weeks after gynecologic laparoscopic surgery. Occasionally you may have an episode of heavy bleeding when you stand up or after urinating. If heavy bleeding is continuous you should contact immediately to your surgeon.
Women who have minimally invasive abdominal surgery (laparoscopic or robotic) have small incisions and are usually sent home with stitches (sutures) or tape strips (Steri-strips). Laparoscopic surgery is used for many types of gynecologic procedures; this may include removal or an ovarian cyst, treatment of endometriosis, removal of uterine fibroids, or hysterectomy.

Staples and certain types of skin sutures are usually removed within 3 to 10 days, either before you leave the hospital or in the surgeon's office. Sutures may also be absorbable; this type of suture does not need to be taken out. Sutures under the skin or inside the vagina do not need to be removed.
  • If there is a bandage dressing on the incision, you can take it off 24 to 48 hours after surgery.
  • Tape strips may be removed gently at home (if they have not fallen off) approximately one week after surgery. Soaking the strips with a warm, wet cloth or taking a shower may make the strips easier to remove.
  • Abdominal incisions should be kept clean by showering. It is not necessary to put soap on the incision; plain tap water is adequate. Avoid scrubbing the area.
  • The way your scar looks will change over time and may not reach its final appearance for up to a year. The area may feel either numb or sensitive to touch, which is normal.
  • Unless directed by the surgeon, do not apply creams, ointments, or other substances to the incision. If the incision appears red, drains more than a drop or two of blood or fluid, drains pus, or begins to open, you should call your surgeon.
You should not hesitate to call the office (9811416848), if you develop any of the following symptoms: 
  1. Redness, warmth or heavy bleeding from the incisions
  2. Fever (above 100.5) or chills
  3. Problems with urination or bowel movements
  4. Heavy vaginal bleeding or increasing abdominal pain
  5. Vomiting
  6. Shortness of breath or chest pain
You should send an email also to contact@laparoscopyhospital.com
It is normal to feel tired for a day or two after surgery, especially if general anesthesia was used. If you have major gynecological laparoscopic surgery, you may feel tired of longer. Taking a few short naps during the day or resting when you are tired may help.

While rest is important, it is also important to walk around several times per day, starting on the day of surgery. This helps to prevent complications, such as blood clots, pneumonia, and gas pains. You can resume your normal daily activities as soon as you are comfortable doing them. Walking and stair climbing is fine. Gradually increase your activity level as you are able.

Other activities like exercise, housework, active sports, can be resumed gradually, as you are able and depending upon the type of surgery. Your surgeon can give you specific instructions.
Not being able to get pregnant is called infertility. Infertility can result if endometriosis causes changes in your pelvic organs, including your fallopian tubes and ovaries. With early laparoscopic surgical treatment, endometriosis should not interfere with your ability to become pregnant. Other factors are also there besides endometriosis which can affect your fertility.
Most of the female will not require any more laparoscopic procedures in the future, but some may. This depends on many factors, such as when your last procedure was, if you are having a problem with pain control while taking medication and if your gynecologist feels it is necessary to check to see if your endometriosis has grown. If your endometriosis has grown, the lesions will be removed and/or destroyed. The goal is to lower your pain and preserve your fertility.

 

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World Laparoscopy Hospital, Cyber City, Gurugram, NCR Delhi, 122002, India

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