Laparoscopic surgery is different for everyone. Each
of us will have a different experience based on our
expectations, the extent of surgery, the length of
surgery, the surgeon, the facility, the nursing staff,
how we respond to pain, and a variety of other factors.
Additionally, each person heals differently. What
is true for one person may not be true for another.
Medical professionals may tell us it takes only a
few days to recuperate from a laparoscopy. Yet most
of us have found that true healing takes much longer
than that, usually several weeks.
Since few resources exist that discuss laparoscopy
from a patient's perspective, the following information
was compiled to give women a better idea of what is
involved before and after laparoscopy.
Overview of the procedure
Laparoscopy is usually done under general anaesthesia.
Generally, a small incision is made near the belly
button and the abdomen is filled with CO2 gas. This
lifts the abdomen away from the internal organs, giving
the surgeon a better view. The lighted laparoscope
is then inserted into the abdomen. Two other small
incisions may be made in the abdomen so additional
surgical instruments, such as a probe to move organs,
can be used during the surgery. Many surgeons also
attach a video camera to the laparoscope to enlarge
the view, allowing the entire surgical team to see
the procedure.
During the laparoscopy, the doctor examines the pelvic
organs, looking for obvious and atypical endometriosis
lesions as well as endometriomas (endometriosis-filled
cysts), adhesions, and scarring. Depending on your
history and symptoms, the doctor may also look for
fibroid tumours or other abnormalities. Other procedures,
such as a hysteroscopy (an examination of the inside
of the uterus) may also be performed.
Diagnosis and treatment of endometriosis may take
place during the same procedure. Your doctor may also
remove the lesions to send to a lab for biopsy. This
will document the presence or absence of endometriosis.
Length of stay
Laparoscopy is usually done on an outpatient basis,
although an overnight stay may be required if the
surgery is complex or lengthy. If a bowel resection
or partial bowel resection is performed, your hospital
stay may be extended by several days. It’s a
good idea to be mentally prepared to spend at least
one night.
Fears
Almost everyone has some fears about surgery. We may
worry about the risks, the anaesthesia, the pain,
or what the surgeon may (or may not) find. If you’re
scared, it helps to determine what you're afraid of,
then work toward minimising that particular fear.
For example, if you’re afraid of the anaesthesia,
talk with your doctor and the anaesthesiologist before
the procedure to discuss your fears. If you are afraid
of the pain, ask your doctor exactly how your pain
will be managed. Many women have found that relaxation
tapes before, during, and after surgery also help
allay fears. Click here for more information.
What should you take to the hospital?
Pack very loose clothing to wear after surgery, preferably
something without a waistband. An oversized pullover
dress is ideal. You may also want to take mini-pads,
socks, and slip-on shoes or house slippers. If there
is a possibility you may be staying overnight, consider
packing a hairbrush, lotion, bathrobe, toothbrush/toothpaste,
and maybe a stuffed animal.
Bowel prep
The surgeon often orders a bowel prep the evening
before surgery. The process varies, but usually includes
a liquid diet and various preparations to evacuate
your bowels. This is not a pleasant process, but it
is necessary if any bowel work is anticipated. For
more information, see our article about how
to survive a bowel prep.
Pain immediately following surgery
When you come out of the anaesthesia in the recovery
room, you may be in some pain. If so, be sure to speak
up so your pain can be properly managed. Coming out
from anaesthesia will also make you feel cold. Ask
for more warm blankets if you’re chilled. You
may also have a sore throat from the tube that's put
in your throat during surgery. If any symptom becomes
bothersome, tell the nurse or doctor. In most cases,
you’ll be given a prescription for pain medication
to take at home. If possible, have this prescription
filled prior to your discharge or very soon thereafter.
Have a buddy
Even if your surgery is scheduled to be on an outpatient
basis, you will be required to have someone drive
you home. It’s a good idea to choose someone
who is helpful and supportive and who can assist you
into the house. If they can stay overnight in your
home, even better. At least for the first evening,
you will be groggy and may have some difficulty getting
around.
Shoulder pain
One of the most disconcerting things about laparoscopy
is the subsequent shoulder pain. This is caused by
the CO2 gas becoming trapped against the diaphragm.
Heat and analgesics often bring relief. Be assured
that time will take care of this pain. For more information
about how to manage shoulder pain, click
here.
Nausea
It seems that most of us experience some nausea after
laparoscopy. Many medications exist to help with this.
Some can be taken before surgery, some during, and
some after. Talk with your doctor and/or anaesthesiologist
beforehand about the methods they use to minimise
nausea. Many women find that nausea is lessened when
they lay flat. Some natural remedies, such as ginger
tea, may also alleviate nausea. To be on the safe
side, always ask your health care professional before
taking any herbs or supplements.
Length of recovery
For the first two or three days following laparoscopy,
most women are tired and groggy. During this time,
it helps to have a family member or friend remain
close by. You may want to put this person in charge
of managing your medications for the first couple
of days. You will probably also need someone to fix
your meals for a short time.
Recuperation during the first two weeks
Your doctor may restrict driving for two weeks following
laparoscopy. Intercourse, tub bathing, douching, and
swimming will also be restricted. Don't expect too
much of yourself for the first few days. You will
probably be very tired and need lots of naps. However,
be sure to get up and move around as you’re
able. You will recover more quickly if you move about.
Post-op blues
Most of us experience a period of emotional ups and
downs following surgery. For some, the blues remain
for several weeks. It's not unusual to cry easily
or become anxious, agitated, frightened, or suspicious.
Some of us have also experienced nightmares following
surgery. All of this will pass in time and you will
begin to feel in control again. Be gentle and patient
with yourself during your physical and emotional recovery.
Incisional numbness
You may feel a "pins and needles" sensation
at the incision site. This is due to the nerves being
cut. Over time, the nerves will heal and the sensation
will subside. If you have bothersome symptoms at the
incision site, such as a knot, swelling, or redness,
contact your doctor.
Loose clothing following surgery
Most of us have found that comfy clothes are very
welcome during the first few weeks after laparoscopy.
The incision site will be tender and the abdomen swollen.
Therefore, you probably won't want to wear anything
snug around the middle. If you don't have many loose-fitting
clothes, you may want to purchase a few outfits prior
to surgery.
First menstruation following surgery
Experiences with the first menstrual period vary dramatically.
If your period is more painful, longer, or heavier
than usual, don't panic. Internal healing takes much
longer than external healing. Therefore, your first
few periods may be more painful. However, if you are
concerned about the degree of pain, or if your pain
is severe, contact your doctor.
Talk with others
Talking with others about their experiences is also
beneficial. Most women in endometriosis support groups
have had a laparoscopy and can provide valuable information
to anyone going through it for the first time.
© 1996-2003 Ellen T Johnson
Reprinted with permission
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