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Complication of Laparoscopic Endometriosis Surgery
Discussion in 'All Categories' started by Venessa - May 3rd, 2018 12:22 pm.
Venessa
Venessa
I do hope you receive this email. I have found your details on the World Laparoscopy Hospital website.

I am writing to enquire if you could possibly advise me?

I had my third laporoscopic operation a couple of years ago, and since then, have been trying to find answers as to what went on in that operation and why I have suffered so much pain since.


I had a history of endometriosis and have not so long ago been diagnosed with hypermobility (about 5 or 6, I think, on the scale).

I had a large blood filled endometriotic cyst removed from my right ovary in 2012 (I think), then within a few weeks thereafter was readmitted and had to have another operation to remove another two cysts (a chocolate cyst with a dermoid cyst inside) and the right ovary itself. These cysts reformed at an astonishing rate. These were planned operations and I had them carried out privately, by the same surgeon. Both laporoscopically.

The remaining left ovary went polycystic and then started growing a large endometriotic cyst. I was booked in for surgery again – this time on our NHS, which is not private, but it was the with the same surgeon. The surgery took place on 20 April 2016, when I was 46 years old.

By the time the surgery came round, I had been experiencing heavy bleeding on menstruation and increased pain and so I said to the surgeon to take my ovary if she needed to, as I thought things had worsened. This would put me into a surgically induced menopause but I had to be realistic. I have not had any children. I am now 48 years old.

When I came out of the surgery, I remember waking up in a bed on the Day Surgery ward. The staff had wrapped lots of blankets around my head.. My partner was waiting for me and he said I had been a long time. I remember nothing about recovery. They said I had been very cold in recovery. My blood pressure was low.

I had a very bad pain in my ribs – right had side at the top towards the top of my stomach primarily. The surgeon came to see me. She said she had taken the ovary. It was very large, she said, and it had moved inside my body.

I said that was not unexpected that she had taken the ovary and it was okay. She left and I was left with the nursing staff.

I felt very poorly but they sent me home the same day. They said it was Day Surgery and there was no overnight beds. I could barely walk. My partner had to drive the car around to the door and literally carry me to the car. The rib pain was immense.

I went with the pain for a couple of days as it was the weekend and the GP surgery was not open. I went to the GP on the Monday and she sent me to hospital. I was there for five days. They did an ultrasound but could not find anything wrong, but the pain was ongoing. They mixed up my blood results with someone else’s on the ward and thought I had an infection, so gave me intravenous antibiotics. Before I was discharged, they said they had got that wrong and I had had no infection but that the antibiotics would have done no harm.

Deep breathing was difficult. Sometimes, I would need to push on the outside of my rib cage in order to get my breath. I could only eat small amounts of food without feeling full up and I could not walk without hunching over, similarly reaching my arms up was also painful. The shape of my abdomen also changed. My belly button and line of tummy to either side seemed a bit taughter, kind of.

I met with my surgeon, privately, some time after I came out of hospital and she said there was nothing wrong and the operation had been a success. This was not how I saw it and as things were not getting better, I saw her again. She recommended HRT – which I have not opted to take – and said for me to speak to the anaesthetist in case they could shed any light on things. She did not examine me the second time. She said the ovary was large and she had to blow me up that big in order to get it out. (Also, there was the matter of the ovary having moved).

My GP sent me for limited sessions of physio and osteopathy to see if they could help. These two things did not help. The physio commented that my diagphram was in spasm and was flat on the right hand side. There is a small amount of puffiness still where the pain is on the right, at the top of my ribs.

At this time, I went to a general surgeon as well, for him to look at my abdomen as I was having increasing pain on the left hand side. It is definitely distended here. He diagnosed an incisional hernia and said there was probably nerve damage to the site as well. He said a light should have been shone to see where the blood vessels were, so there was a good idea of where the nerves were, when the incision was made. I still have the hernia – it is only small and currently I am not worried about it, but there is pain and distortion to the left side. I asked him about the rib pain, but he shook his head.

I reported back to the surgeon that did the operation, that I had an incisional hernia. She responded by saying when she saw me in clinic, there was no evidence of a hernia – well, this is because she did not examine me, so how would she have seen one? (this retort of hers did upset me).

My appointment to see the anaesthetist came round months later – I had to wait ages. The meeting was with the manager of the department, not the anaesthetist who treated me on the day. My throat was really red and purple after the operation and in fact I did not take much to the anaesthetist, if I am honest. I asked whether the anaesthetist had put the gas into my tummy. She said it would not have been the anaesthetist but they do put a small amount of gas in the lungs to inflate them.

Please could you confirm if it is the anaesthetist or the surgeon who puts in the gas, to enlarge the abdomen?

I think they over inflated me? Maybe the machine was faulty and the valve did not cut out? I really want answers.

The anaesthetist shrugged her shoulders. She did examine me though and saw there was an issue – she referred me to her colleague at the Pain Clinic. Again, weeks and weeks went by before I saw anyone.

The Pain Clinic doctor thinks it maybe the rectus abdominus muscle that is causing pain, but this has not been confirmed. She went off sick for months and I’m still waiting to see her for a follow up and further assessment. I think she may also do a nerve block to the hernia site.

I can’t believe anyone else in the world has never complained about acute and chronic rib pain after a laporoscopy before. I’ve been passed around the NHS, having had to wait months for appointments, and noone will confirm what has happened. Have you ever come across these symptoms post-laparoscopy before? I did not suffer this way after my previous two laparoscopy operations.

I do have prolapsed discs in my spine. At the time of surgery, I had an old prolapsed disc in my neck and at L5/S1 diagnosed. Since the operation, due to breathing and rib pain issues, I have not been able to carry on with my pilates classes and further disc prolapses have taken place. I have consulted an orthopaedic surgeon and neurosurgeon here and they confirm that my pain is not related to the current disc issues.

If you could help me, I would be so grateful. The truth is, my ribs are better than immediately post surgery, so I have improved over the last two years, but I am still in pain and still do not know why. It’s the top of my right hand side ribs that is the worst. The left side of my abdomen is also enlarged, compared to the right, and I have been told it could be my bowel that is in spasm or I may have attachments; there is the matter of the small incisional hernia here too, but this is low down and the enlarged area is above this. I trusted the surgeon, as she had performed two laporoscopic operations well previously, but this time things did not go well and I have issues that are still unanswered. I wish I had not had the last operation done on the NHS; the private operations both went well. If the NHS had even tried to put things right, within a reasonable amount of time, I would not feel so let down.

It would be great to hear from you with any information that you think might help me. Obviously I am not a trained doctor or health care worker, so layman’s terms would be great. I’m trying to remain positive!

Best wishes and thanks in advance,
re: Complication of Laparoscopic Endometriosis Surgery by Dr R K Mishra - May 3rd, 2018 12:32 pm
#1
Dr R K Mishra
Dr R K Mishra
Dear Venessa

Sorry for your problems you are facing. The CO2 is feed in abdomen by surgeon not the anesthetist but pressure given is not enough to damage the rib. It could be due to some other reason. I dont think it is directly due to surgery but it may be some electrical injury during surgery. Now to identify that injury I need to see the video of your surgery. Generally we record our video and give it to the patient. If you can send your video I can answer your questions.


Sincerely Yours

With regard,

Dr. R.K. Mishra. MBBS, MS, MRCS, Dip. LAP, FICRS, FIMSA
Chairman World Laparoscopy Hospital, Gurgaon, India
Professor and Head of Minimal Access Surgery, TGO University, India
First University Qualified Master Minimal Access Surgeon of India (M.MAS)
Editor in Chief World Journal of Laparoscopic Surgery (WJOLS)
General Secretary World Association of Laparoscopic Surgeon (WALS)
General Secretary International College of Robotic Surgeons (ICRS)
Member European Association for Endoscopic Surgery (EAES)
Member European Association for Transluminal Surgery (EATS)
Member Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)
Member Society of Laparoendoscopic Surgeons (SLS)
Member Society of Robotic Surgery (SRS)
Member Clinical Robotic Surgery Association (CRSA)
Fellow of International Medical Sciences Academy (IMSA)
Member Indian Association of Gastrointestinal Endosurgeons (IAGES)
Member Association of Surgeons of India (ASI)
Member Indian Medical Association (IMA)
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