Laparoscopic Surgery (Endometriosis)

Why would you be having laparoscopic surgery?

Laparoscopic surgery is the only real way to diagnose endometriosis. Your gynecologist or even family doctor may have made an assumptive diagnosis based on your symptoms, but a true diagnosis can only be made when the endometrial adhesions are seen. The description of the surgery suggests that the doctor intends to merely look and see if adhesions are present, but once adhesions are found they are removed during the same procedure. Endometrial adhesions are most frequently found on the ovaries and fallopian tubes, but may be present anywhere in the abdomen. Endometriosis on the ovaries can form cysts, called endometrioma.

What you can expect

You may be instructed to not eat or drink for at least eight hours leading up to the procedure. Most laparoscopies are outpatient procedures. That means you don’t need to stay at the clinic or hospital overnight. However, if there are complications, you may need to stay longer. It’s a good idea to pack a few personal items just in case.

Arrange for a partner, family member, or friend to drive you home and stay with you after your procedure. General anesthesia can cause nausea and vomiting, too. Having a bag or bin ready for the car ride home is a good idea.

You might be instructed not to shower or take a bath for up to 48 hours following a laparoscopy to allow the incision to heal. Showering right before the procedure might make you feel more comfortable.

You’ll be given a general or a local anesthetic prior to the surgery to induce either general or local anesthesia. Under general anesthesia, you’ll fall asleep and not feel any pain. It’s usually administered through an intravenous (IV) line, but may also be given orally. Under local anesthesia, the area where the incision is made will be numb. You’ll be awake during the surgery, but won’t feel any pain.

During the laparoscopy, your surgeon will make an incision in your abdomen, typically under your belly button. Next, a small tube called a cannula is inserted into the opening. The cannula is used to inflate the abdomen with gas, usually carbon dioxide or nitrous oxide. This helps your surgeon to see the inside of your abdomen more clearly.

Your surgeon inserts the laparoscope next. There’s a small camera on the top of the laparoscope that allows them to see your internal organs on a screen. Your surgeon may make additional incisions to get a better view. This can take up to 45 minutes.

When endometriosis or scar tissue is found, your surgeon will use one of several surgical techniques to treat it. These include:

• Excision. Your surgeon will remove the tissue.
• Endometrial ablation. This procedure uses freezing, heating, electricity, or laser beams to destroy the tissue.

Once the procedure is finished, your surgeon will close the incision with several stitches and the air in your abdomen is released.

You will be under restrictions for 2 weeks following your surgery. Abdominal surgery requires cutting abdominal muscles, and the abdomen is your core, it is used when moving almost any part of your body. The restrictions are in your best interests, and in the best interests of your healing body.

Problems that may arise and ways to troubleshoot

You may notice pain or cramping in your neck, shoulders, or upper arms for a few days following surgery. This pain is a result of the trapped air from the inflation of your abdomen. Some air gets trapped and is not released when your abdomen deflates. This air “floats” in your body, moving to the highest part of your body. Lying as flat as possible, or with your legs elevated will disperse this trapped air, spreading it out and not allowing it to concentrate in one area. The air is gradually absorbed into your bloodstream and released within a few days. A way to encourage that absorption is a heating pad and/or massage. When the area has a greater blood flow the trapped air is absorbed faster.

As with all surgeries, your incisions are very important. If they become more painful, red, swollen, or begin producing a discharge, see your doctor immediately.

Tips

After your surgery, you can ease the recovery process by:

• getting enough rest
• eating a mild diet and drinking enough fluids
• doing gentle movements to help eliminate excess gas
• taking care of your incision by keeping it clean and out of direct sunlight
• giving your body the time it needs to heal
• contacting your doctor immediately if you experience complications. You should avoid certain activities immediately after your surgery.