Laparoscopic and Hysteroscopic Surgeries
What is Laparoscopy
Laparoscopy is a surgical procedure performed through very small incisions in the abdomen. A pencil-thin telescope called a laparoscope is used to visualise your internal organs. Further one to two small incisions may be needed for mini surgical instruments. The advantages of laparoscopy are:
· Shorter hospital stay
· Quick recovery
· Less post-operative pain
· Less scarring tissues
. Fewer complications
What will be done?
This procedure will allow visualisation of the internal organs and may be combined with specific treatment, such as:
· Resection of endometriosis.
· Removal of ovarian cysts
· Removal of fibroids
· Removal of the uterus and cervix (Hysterectomy)
· Removal of one /both ovaries or the tubes
· Division of adhesions (scarring tissues).
Why is this done?
Common reasons are:
· Pelvic pain / Endometriosis
· Painful or heavy periods
· Pelvic swelling (such as ovarian cysts)
· Tubal disease
· Treatment of ectopic pregnancy
· Fertility assessment and treatment.
You should have a clear understanding of your reason for this surgery.
What are the alternatives?
Alternatively, similar procedures may be performed by open surgery (laparotomy). This is a much more invasive procedure, involving higher complications, increased hospitalisation and recovery. However, in certain situations a laparotomy may be indicated.
How is the Laparoscopy done?
The procedure is normally performed under a general anaesthetic in the operating theatre. A drip is inserted into your arm to sleep. An examination is made under anaesthesia and instruments may be inserted into the vagina. A small incision is into your umbilicus. The abdomen is inflated with special gas and the laparoscope is inserted through this incision to visualise the internal organs. Further small incisions may be made in your abdomen if any abnormalities require treatment. At the end, the gas will be allowed to come out. The wounds are closed with dissolvable sutures. The procedure itself can takes sixty minutes or more based on the type of the treatment you have received, but you can expect to be in theatre and recovery for a number of hours.
What are the complication of this procedure?
Every surgical procedure has associated risks however with laparoscopic surgery the complications are less compared to open surgery.
Complications include, but are not limited to:
1. The anaesthetic
2. The surgery – Injuries to bladder, ureters (the tube connecting the kidney to the bladder), bowel or blood vessels, requiring further surgery, blood transfusion or longer admission; the procedure may not be able to be completed laparoscopically, and you may require an “open” operation with an increased hospital stay
3. The recovery period and possible side effect include:
Nausea, vomiting or pain necessitating overnight admission
Infections of the bladder, wound, tummy
Blood clots that may in the leg or the lung
Variable postoperative pain
What is Hysteroscopy?
Hysteroscopy is surgical procedure using a small scope through the vagina and into the cervical opening viewing the inside of the uterus. This will also includes visualisation the openings of Fallopian tubes, as well as direct examination of the cervix, cervical canal, and vagina.
Hysteroscopy may be preformed as an outpatient surgery under local anaesthesia or in a hospital operating room under general anaesthesia.
Why is Hysteroscopy done?
Hysteroscopy can be performed for both diagnosis or also for treatment (therapeutic).
Common reasons:
· Heavy and painful periods, and in abnormal vaginal bleeding
· Removal of Polyps or fibroid at the cervical canal or inside the uterine cavity
· Freeing of scarring, or adhesions inside the uterus or cervix
· Removal of retained placenta or products of conception
· Evaluation or treatment of abnormalities at the uterus or cervix.
· Evaluation of the uterus in recurrent miscarriages problem
· Endometrial ablation
What are the risks and complications of Hysteroscopy?
It is expected to experience light vaginal bleeding and some cramping after the hysteroscopy procedure.
Complications of hysteroscopy are rare and include:
· Bleeding,
· Infection,
· Perforation of the uterus which may lead to Injury to the bladder or bowel. Accidental perforation of the uterus is rare and occurs in 0.1% of diagnostic hysteroscopy procedures and 1% of therapeutic hysteroscopies. Other rare complications are fluid overload or gas embolism (when gas bubbles enter the bloodstream) from the distending medium used in the therapeutic procedure.
Any specific risks and complications will be discussed prior to the procedure. So, please make sure that all your questions were answered prior to the operation and that you have a complete understanding of the risks, benefits and complications of the scheduled surgery. If you have any additional questions please do not hesitate to contact me even if this required an additional clinic visit.
What should I do before my procedure?
Any investigations or arrangements at the preoperative consultation should have been completed. You should continue your regular medications with only a sip of water unless advised otherwise. You may be required to have a bowel preparation, which will empty your bowel prior to the surgery. If this is required which is rare, you should only have fluids (soups, tea, jellies, juices or similar drinks) in the 24 hours prior to the surgery. The bowel preparation medication should be taken as ordered. Also, you must carefully follow any preoperative treatment: antibiotic, etc. The outcome of the procedure depends on a thorough adherence to the prescribed treatment.
If you are expecting your period close to your surgery, it is unlikely to interfere with your surgery but it is advisable to update your surgeon. On the other hand, if you are pregnant or you believe that you might be pregnant please tell us as soon as possible. Smoking should be stopped. Should you develop an illness prior to your surgery, please contact our office immediately.
Please delegate one person (if you wish) who will communicate on your behalf until you are fully awake and please indicate what type of information should be passed.
What should I do on the day of my procedure?
Unless otherwise specified, you should stop eating and drinking at the following times on the day of the surgery:
1. At midnight for a morning procedure; or
2. At 7 am for an afternoon procedure
You should continue all your usual medications and clear water, unless otherwise specified.
You should bring:
· Toothbrush / paste / toiletries
· Nightgown
· Underwear
· Sanitary pads
· All usual medications
· All X Rays, scans or pervious operative photos if available.
Please make an arrangement for somebody to drive you home and look after you for the first 24h following your surgery
What should I expect after my procedure?
When you wake from the anaesthetic, you will be in the recovery room. Depending on the procedure, you may be able to leave that day but be prepared to stay overnight when required or previously planned.
You should expect:
· Some abdominal discomfort
· Bloating
· May experience some shoulder tip pain, related to the gas used in the procedure.
· May have slight vaginal bleeding for 3 to 5 days after surgery.
You will be given specific discharge medication including painkillers but you may use Panadol as required (one to two tablets every four hours up to a maximum of eight tablets per day). Please ensure you received a pain medication prescription before leaving the hospital.
After discharge from hospital, you should:
You should not:
· Undertake any unsupervised activity on the day of the procedure
· Cover the wound unless oozing
· Have intercourse for two weeks
· Undertake any heavy exercise, lifting, cycling, swimming or straining for at least one week
· Drive until you can comfortably operate foot pedals or change gears (please contact and check with your motor insurance company)
· Going back to work can take between one to two weeks unless otherwise specified.
· Your sutures are dissolvable that do not require removal but you may notice yellowish discharge or even a stitch may came off
which is normal. This may take up to three weeks.
Usually you will be scheduled for post-operative follow up appointment 2 – 4 weeks after your surgery.
What if I have any problems?
You should seek medical attention if you experience:
· Fever or feeling unwell
· Offensive vaginal discharge or heavy bleeding
· Wound becomes hot, painful or discharges offensively
· Intractable nausea or vomiting
· Inability to empty your bladder or bowels
· Severe pain
Please contact the office on 0863730126 or me on mobile-phone provided if you require urgent attention. Alternatively you can report to your GP or Hospital Emergency Department.
N.B. Any surgical intervention is very complicated task which requires involvement and cooperation of a large number of professionals. We kindly request your courtesy to give us 48 hours notification in case of any cancellation
Laparoscopy is a surgical procedure performed through very small incisions in the abdomen. A pencil-thin telescope called a laparoscope is used to visualise your internal organs. Further one to two small incisions may be needed for mini surgical instruments. The advantages of laparoscopy are:
· Shorter hospital stay
· Quick recovery
· Less post-operative pain
· Less scarring tissues
. Fewer complications
What will be done?
This procedure will allow visualisation of the internal organs and may be combined with specific treatment, such as:
· Resection of endometriosis.
· Removal of ovarian cysts
· Removal of fibroids
· Removal of the uterus and cervix (Hysterectomy)
· Removal of one /both ovaries or the tubes
· Division of adhesions (scarring tissues).
Why is this done?
Common reasons are:
· Pelvic pain / Endometriosis
· Painful or heavy periods
· Pelvic swelling (such as ovarian cysts)
· Tubal disease
· Treatment of ectopic pregnancy
· Fertility assessment and treatment.
You should have a clear understanding of your reason for this surgery.
What are the alternatives?
Alternatively, similar procedures may be performed by open surgery (laparotomy). This is a much more invasive procedure, involving higher complications, increased hospitalisation and recovery. However, in certain situations a laparotomy may be indicated.
How is the Laparoscopy done?
The procedure is normally performed under a general anaesthetic in the operating theatre. A drip is inserted into your arm to sleep. An examination is made under anaesthesia and instruments may be inserted into the vagina. A small incision is into your umbilicus. The abdomen is inflated with special gas and the laparoscope is inserted through this incision to visualise the internal organs. Further small incisions may be made in your abdomen if any abnormalities require treatment. At the end, the gas will be allowed to come out. The wounds are closed with dissolvable sutures. The procedure itself can takes sixty minutes or more based on the type of the treatment you have received, but you can expect to be in theatre and recovery for a number of hours.
What are the complication of this procedure?
Every surgical procedure has associated risks however with laparoscopic surgery the complications are less compared to open surgery.
Complications include, but are not limited to:
1. The anaesthetic
2. The surgery – Injuries to bladder, ureters (the tube connecting the kidney to the bladder), bowel or blood vessels, requiring further surgery, blood transfusion or longer admission; the procedure may not be able to be completed laparoscopically, and you may require an “open” operation with an increased hospital stay
3. The recovery period and possible side effect include:
Nausea, vomiting or pain necessitating overnight admission
Infections of the bladder, wound, tummy
Blood clots that may in the leg or the lung
Variable postoperative pain
What is Hysteroscopy?
Hysteroscopy is surgical procedure using a small scope through the vagina and into the cervical opening viewing the inside of the uterus. This will also includes visualisation the openings of Fallopian tubes, as well as direct examination of the cervix, cervical canal, and vagina.
Hysteroscopy may be preformed as an outpatient surgery under local anaesthesia or in a hospital operating room under general anaesthesia.
Why is Hysteroscopy done?
Hysteroscopy can be performed for both diagnosis or also for treatment (therapeutic).
Common reasons:
· Heavy and painful periods, and in abnormal vaginal bleeding
· Removal of Polyps or fibroid at the cervical canal or inside the uterine cavity
· Freeing of scarring, or adhesions inside the uterus or cervix
· Removal of retained placenta or products of conception
· Evaluation or treatment of abnormalities at the uterus or cervix.
· Evaluation of the uterus in recurrent miscarriages problem
· Endometrial ablation
What are the risks and complications of Hysteroscopy?
It is expected to experience light vaginal bleeding and some cramping after the hysteroscopy procedure.
Complications of hysteroscopy are rare and include:
· Bleeding,
· Infection,
· Perforation of the uterus which may lead to Injury to the bladder or bowel. Accidental perforation of the uterus is rare and occurs in 0.1% of diagnostic hysteroscopy procedures and 1% of therapeutic hysteroscopies. Other rare complications are fluid overload or gas embolism (when gas bubbles enter the bloodstream) from the distending medium used in the therapeutic procedure.
Any specific risks and complications will be discussed prior to the procedure. So, please make sure that all your questions were answered prior to the operation and that you have a complete understanding of the risks, benefits and complications of the scheduled surgery. If you have any additional questions please do not hesitate to contact me even if this required an additional clinic visit.
What should I do before my procedure?
Any investigations or arrangements at the preoperative consultation should have been completed. You should continue your regular medications with only a sip of water unless advised otherwise. You may be required to have a bowel preparation, which will empty your bowel prior to the surgery. If this is required which is rare, you should only have fluids (soups, tea, jellies, juices or similar drinks) in the 24 hours prior to the surgery. The bowel preparation medication should be taken as ordered. Also, you must carefully follow any preoperative treatment: antibiotic, etc. The outcome of the procedure depends on a thorough adherence to the prescribed treatment.
If you are expecting your period close to your surgery, it is unlikely to interfere with your surgery but it is advisable to update your surgeon. On the other hand, if you are pregnant or you believe that you might be pregnant please tell us as soon as possible. Smoking should be stopped. Should you develop an illness prior to your surgery, please contact our office immediately.
Please delegate one person (if you wish) who will communicate on your behalf until you are fully awake and please indicate what type of information should be passed.
What should I do on the day of my procedure?
Unless otherwise specified, you should stop eating and drinking at the following times on the day of the surgery:
1. At midnight for a morning procedure; or
2. At 7 am for an afternoon procedure
You should continue all your usual medications and clear water, unless otherwise specified.
You should bring:
· Toothbrush / paste / toiletries
· Nightgown
· Underwear
· Sanitary pads
· All usual medications
· All X Rays, scans or pervious operative photos if available.
Please make an arrangement for somebody to drive you home and look after you for the first 24h following your surgery
What should I expect after my procedure?
When you wake from the anaesthetic, you will be in the recovery room. Depending on the procedure, you may be able to leave that day but be prepared to stay overnight when required or previously planned.
You should expect:
· Some abdominal discomfort
· Bloating
· May experience some shoulder tip pain, related to the gas used in the procedure.
· May have slight vaginal bleeding for 3 to 5 days after surgery.
You will be given specific discharge medication including painkillers but you may use Panadol as required (one to two tablets every four hours up to a maximum of eight tablets per day). Please ensure you received a pain medication prescription before leaving the hospital.
After discharge from hospital, you should:
- Eat and drink normally
- Make sure you passing urine normally
- Remain mobile, though lying flat may reduce your shoulder discomfort if this proves to be troublesome
- Use sanitary pads (not tampons) if required
- Shower normally (in preference to bathing)
- Remove the dressings after 24hrs and rinse any wounds gently with soap and water
You should not:
· Undertake any unsupervised activity on the day of the procedure
· Cover the wound unless oozing
· Have intercourse for two weeks
· Undertake any heavy exercise, lifting, cycling, swimming or straining for at least one week
· Drive until you can comfortably operate foot pedals or change gears (please contact and check with your motor insurance company)
· Going back to work can take between one to two weeks unless otherwise specified.
· Your sutures are dissolvable that do not require removal but you may notice yellowish discharge or even a stitch may came off
which is normal. This may take up to three weeks.
Usually you will be scheduled for post-operative follow up appointment 2 – 4 weeks after your surgery.
What if I have any problems?
You should seek medical attention if you experience:
· Fever or feeling unwell
· Offensive vaginal discharge or heavy bleeding
· Wound becomes hot, painful or discharges offensively
· Intractable nausea or vomiting
· Inability to empty your bladder or bowels
· Severe pain
Please contact the office on 0863730126 or me on mobile-phone provided if you require urgent attention. Alternatively you can report to your GP or Hospital Emergency Department.
N.B. Any surgical intervention is very complicated task which requires involvement and cooperation of a large number of professionals. We kindly request your courtesy to give us 48 hours notification in case of any cancellation