Gynaecological surgery

Laparoscopy is a surgical method that allows the examination and treatment of abdominal organs without the need for a large incision in the abdominal wall.

Description of Laparoscopy

• Laparoscopy is performed under general anesthesia.
• First, the abdominal cavity is filled with carbon dioxide gas using a special needle. Then, a small incision is made in the abdominal wall near the navel, through which a laparoscope is inserted into the abdominal cavity. The laparoscope allows visualization of the abdominal cavity from the inside. Additionally, 1-3 small incisions are made in the abdominal wall through which surgical instruments are inserted.
• With this surgical method, it is possible to remove adhesions, ovarian cysts, fibroids, endometriosis lesions, uterus, ovaries, and/or fallopian tubes from the abdominal cavity. It is also used in the treatment of malignant gynecological tumors. In addition to examining organ anatomy, laparoscopy can be used to assess the patency of the fallopian tubes for infertility investigation.
• Laparoscopy is a minimally invasive surgical method, and the small incisions allow for faster postoperative recovery.

Preparation for Surgery

• Your treating physician will create the most suitable treatment plan for you and provide the necessary instructions before the surgery.
• On the day of surgery, take a shower in the morning. Your surgery will be performed under general anesthesia, and to avoid complications, you must fast for at least 6 hours and avoid drinking for 4 hours before the surgery.
• Please carefully review the checklist for surgery preparation!
• To reduce risks, inform your doctor about your health condition, illnesses, medications you regularly take, and any known allergies to medications.

Surgery

Laparoscopy is performed under general anesthesia, and the duration depends on the planned surgery. After the surgery, the surgical instruments are removed, the gas in the abdominal cavity is expelled, and the small incisions in the abdomen are closed. If tissue samples were taken or an organ or part of an organ was removed during the surgery, the samples are sent for histological examination. Your treating physician will inform you about the results of the histological examination.

Complications are rare with laparoscopy, but the risk is higher in cases of previous abdominal surgeries or the presence of adhesions. Like with any surgery, complications that may occur during laparoscopy include:

• Bleeding
• Infection (wound, abdominal, or surgical site infection)
• Injury to neighboring organs (bladder, ureter, bowel injury)
• Thrombosis
• Formation of adhesions
• Hernia
• Complications related to anesthesia (most commonly associated with allergies)

Note: During laparoscopic surgery, there may be situations where the planned operation is technically not feasible and the desired outcome cannot be achieved. In such cases, the laparoscopy is discontinued, and open surgery is performed.

Postoperative Period

The length of hospital stay depends on the type and duration of the surgery you underwent. Often, after gynecological laparoscopy, it is possible to go home on the same day, while sometimes a hospital stay of 1-2 nights may be required. After laparoscopy, you may experience short-term abdominal pain and shoulder and neck pain. These symptoms usually resolve within 2-3 days. The wound dressings can be removed on the day after the surgery. Clean the skin wounds daily with warm running water and soap. Apply clean wound dressings daily until they become soiled. Your doctor will inform you about the materials used for wound closure. Often, the skin incisions are sutured with self-absorbable sutures that do not require removal. If the stitches need to be removed, your treating physician will inform you and specify the time and place for suture removal.

The postoperative regimen may vary, and your treating physician will provide you with precise instructions. Generally, it is recommended to avoid heavy physical exertion, lifting weights over 5-7kg, taking baths, saunas, swimming, using tampons and menstrual cups, and engaging in sexual activity for one month after laparoscopy. Over-the-counter pain relievers are suitable for alleviating postoperative pain. Within the first week after laparoscopy, it is advisable to follow a light diet, avoiding fatty, spicy, and fried foods.

Follow-up Care

When recovering at home, it is important to consider the following:

• Follow the precise instructions provided by the surgeon who performed the operation.
• If necessary, the treating physician will issue a sick leave certificate.
• In case of the following symptoms after the surgery, seek emergency medical attention:
• Body temperature above 38°C
• Severe abdominal pain
• Digestive and urinary disturbances
• Excessive and foul-smelling vaginal discharge
• Heavy bleeding from the genital area.