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A GUIDE FOR LAPAROSCOPIC SURGERY THIS IS MODERN MEDICINE

A GUIDE FOR LAPAROSCOPIC SURGERY This information is for you if you are about to have or recovering from a laparoscopy keyhole surgery You might also find it useful to share this information with your family and friends What is a Laparoscopy This information is for you if you are about to have or recovering from a laparoscopy keyhole surgery You might also find it useful to share this information with your family and friends A Laparoscopy is a common operation that is carried out to look inside the abdominal and pelvic cavity using a laparoscope This involves passing the laparoscope through a small incision near the umbilicus or belly button The abdomen will then be inflated so all the organs can be visualized Additional 2 3 incisions are made to the left right and possible on the bikini line where it is possible to pass other instruments

You may need a Laparoscopy for a number of reasons To help your gynaecologist make a diagnosis by looking inside your pelvis this is known as a diagnostic laparoscopy as a treatment this is known as an operative laparoscopy treatment of endometriosis removal of an ovarian cyst removal of one or both ovaries treatment of an ectopic pregnancy division of adhesions treatment of uterine fibroids treatment of a prolapse of the vagina or uterus

A Guide for Laparoscopic Surgery Preparation For Your Surgery Consent Form You are required to sign a consent form before your surgery Together you and your consultant surgeon would have discussed the benefits and risks of your surgery at your consultation in clinic You need to understand the surgery you are having If you have any questions please call the Women s Health Centre and speak with a nurse Shortly before your planned surgery the hospital will contact you with an admission time However you also may get a call from the pre operative assessment clinic if this is necessary for you Preparing Your Body For Surgery Bowel Preparation Bowel Prep may be required before your procedure as the surgeon may be looking at the anatomy near your bowel You may receive a prescription and instructions at time of consultation How to take the bowel prep will be on a separate leaflet if this is applicable to you While unpleasant this minimizes the risk of surgical complications from bowel injury during your surgery Hygiene You must shower or bathe the morning of or the night prior to admission Nail polish make up and jewellery should be removed the night before surgery Wear loose fitting clothes to prevent any unnecessary pressure on the umbilicus on the day of surgery No Eating Or Drinking Your stomach needs to be empty before your surgery and it takes 6 hours of fasting for this to happen No water fluids to be taken 2 hours before your admission time Do not smoke or chew gum 2 hours before admission time If you are currently taking medication ask your doctor if you should stop taking it

A Guide for Laparoscopic Surgery What Should I Bring To Hospital Bring loose fitting pajamas or a nightdress nothing with a tight waistband as your abdomen will be tender after the laparoscopy Also remember to bring a pair of shoes slippers and a dressing gown If there is a possibility you may be staying overnight you may want to bring some toiletries and some sanitary towels as spotting after the laparoscopy is normal Admission On the day of your admission your nurse will order some routine bloods to be taken Depending on your age and medical history you may need ECG tracing of your heart rhythm and or a chest x ray either on admission or few days before Your nurse will notify you if you need this Please ask any questions and express any concerns you may have Immediately prior to surgery you will be asked to empty your bladder Glasses contact lenses dentures and jewellery should be removed Valuables should be left in the safekeeping of the person who accompanies you or should be left at home What To Expect After The Laparoscopy Length Of Stay If you are having a diagnostic laparoscopy you should be able to go home on the same day This operation is usually done as a day case When you wake from the anesthetic your nurse will want to make sure that you are not in pain that you have had something to eat and drink and that you have passed urine before you are discharged This usually takes between 3 to 4 hours When you go home make sure you are not alone and someone can stay with you overnight In some cases you may be asked to stay in hospital overnight This will be discussed with you by your Consultant

A Guide for Laparoscopic Surgery How Will I Feel After The Anaesthetic Most modern anaesthetics are short lasting You should not have or su er from any after e ects for more than a day after your operation During the first 24 hours you may feel more sleepy than usual and your judgment may be impaired You should not drink any alcohol after you leave hospital You should have an adult with you during this time and should not drive or make any important decisions Pain And Discomfort You can expect some pain and discomfort in your lower abdomen for the first few days after your operation You may also have some pain in your shoulder This is a common side e ect of the operation When leaving hospital you will usually be provided with a prescription for painkillers It is important you take the painkillers regularly for the first few days Do not take painkillers on an empty stomach You may also have a sore throat after the operation this is due to a tube that is put in place during the surgery to keep your airway open Stitches And Dressings You will have between one and four small scars on di erent parts of your abdomen one scar will usually be in your umbilicus belly button Each scar will be between 0 5 cm and 1 cm long Your cuts will be closed by special glue and paper stitches Some dissolvable stitches may be present these will disappear by themselves

A Guide for Laparoscopic Surgery Going Home After Surgery Tiredness Everyone is di erent and people react and recover in di erent ways You may feel much more tired than usual after your operation as your body is using a lot of energy to heal itself It is important to find a balance Listen to your body and do as much as you feel comfortable Wound Care Initially your cuts will be covered with a dressing You should be able to take these o about 48 hours after your operation leave the paper stitches steri strips for 7 days and have a wash or shower only wash with water i e no soap or body washes Do not put any creams or lotions on your wounds it may interfere with the glue and the healing process Vaginal Bleeding You may get vaginal bleeding for 24 to 48 hours This should lessen over 4 5 weeks after surgery Please do not use any tampons as they can cause an infection sanitary pads are best If you notice a brown green discharge or if you notice an odour you need to contact the clinic and speak with a nurse Please note if you are still menstruating your first period after your procedure may be more painful and heavier than usual This is normal as your body is still healing You can take your usually painkillers if needed

A Guide for Laparoscopic Surgery What Can Help Me Recover It takes time for your body to heal and for you to get fit and well again after a laparoscopy There are a number of positive steps you can take at this time The following will help you recover A daily routine Establish a daily routine and keep it up For example try to get up at your usual time have a wash and get dressed Eat a healthy balanced diet Ensure your body has all the nutrients it needs by eating a healthy balanced diet A healthy diet is a high fibre diet fruit vegetables wholegrain bread and cereal with up to 2 litres a day of fluid intake mainly water Remember to eat at least five portions of fruit and vegetables each day If you cannot manage 3 meals a day you can eat little and often until you feel well enough for regular meals Bowels This varies from patient to patient it usually takes a few days for your bowels to normalize You may have taken bowel prep prior to your surgery which may make your bowels sluggish after your laparoscopy Your bowel habit may be irregular and unpredictable at first but this should settle It is very important to prevent constipation as this wil put pressure in your pelvis Your consultant may advise you to make a mild laxative to help this

A Guide for Laparoscopic Surgery Driving You should not drive for one week after a Laparoscopy However each insurance company will have its own conditions for when you are insured to start driving again You can check your policy provider Before you drive you should be free from the sedative e ects of any painkillers able to make an emergency stop with no pain able to do a three point turn without causing yourself any discomfort able to wear the seatbelt comfortably It is a good idea to practice without the keys in the ignition When you are ready to start driving again build up gradually starting with a short journey Sexual Activity It is safe to have intercourse when you feel ready If your vagina feels dry try using a lubricant You can buy this from your local pharmacy However if you have any pain vaginal bleeding or discharge please do not resume sexual intercourse until these symptoms have subsided Returning To Work You can expect to feel able to go back to work within 1 2 weeks sometimes you might need more time depending on your specific surgery Your consultant will give you a sick cert for work depending on your surgery If you are still not ready to go back to work after the date on your sick cert please see your GP for a further cert

A Guide for Laparoscopic Surgery Formation Of Blood Clot How To Minimize The Risk There is a small risk of blood clots forming in the veins in your legs and pelvis deep vein thrombosis after any operation These clots can travel to the lungs pulmonary embolism which could be serious You can reduce the risk of clots by Wearing Ted Stockings for 2 weeks after your surgery or indicated by your consultant being as mobile as you can as early as you can after your operation doing exercises when you are resting for example pump each foot up and down briskly for 30 seconds and move your ankle in circular motions try to do this every hour when resting bend and straighten your legs one leg at a time three times for each leg every hour when resting When Should I Seek Medical Advice After A Laparoscopy While most women recover well after a laparoscopy complications can occur as with any operation You should seek medical advice from your GP or contact the clinic and speak to a nurse if you experience Burning and stinging when you pass urine or increased urine frequencly this may be due to a urine infection This may need to be treated with a course of antibiotics please see your GP Red painful or hot skin around your scars this may indicate a wound infection Treatment is with a course of antibiotics Worsening abdominal pain If you have a temperature fever have lost your appetite and are vomiting this may be caused by damage to your bowel or bladder in which case you will need to be admitted to hospital No improvement in your symptoms you should expect a gradual improvement of your symptoms over time If this is not the case you should seek medical advice

A Guide for Laparoscopic Surgery Follow Up Care Your consultant will review you within 4 6 weeks post operatively Please call the clinic if you do not have an appointment If you develop any pain that is worsening or are concerned regarding any issues please contact us on the telephone numbers or email addresses overleaf RECOVERY DAYS HOW MIGHT I FEEL 1 2 You may or may not still be in hospital You will still have pain or discomfort in you abdomen Mobilising may increase the discomfort Some bleeding or spotting on your pad is normal 3 7 You should be discharged by now Pain and discomfort to your abdomen should be reducing You may still be tired 1 2 weeks Mobilising should be easier and pain settling Bleeding should be settling Energy levels are returning WHAT IS SAFE TO DO Get out of bed and mobilise Wash and dress yourself Eat and drink as normal Rest between activities for short periods CAN I RETURN TO WORK NO Continue as with days 1 2 NO Shower yourself Increase your mobility to short walks Rest relax if needed in the afternoon Increase exercise slowly Only lift light loads Light household cleaning allowed Your Consultant will inform you when you can return to work 2 4 weeks 4 6 weeks You should have very little or no tenderness or pain to abdomen You should feel stronger and have energy levels back to normal You should be back to normal or almost there Tired at times is still normal You can start to return to normal exercise regime listen to yur bidy and build yourself back up Plan to go back to work YES if you feel ready All daily activities returned Heavy lifting allowed YES You can have sex again if you feel ready Driving allowed after emergency stop tolerated and insurance company notified

Women s Centre Beacon Hospital Sandyford Dublin 18 D18 AK68 Tel 01 293 8684 Email womenscentre beaconhospital ie www beaconhospital ie Version 1 5 2023