Pre-Operative Instructions for Laparoscopy/Hysteroscopy

• What to expect with laparoscopic and hysteroscopic surgery

• Prior to surgery

• What to expect in the operating room

• After surgery

• Care after your surgery at home

• Diet after surgery

• Activity after surgery

• Gas pains after surgery

• Infection

• Sexual activity after surgery

This information is NOT intended as a substitute for medical advice of physicians. The reader should regularly consult a physician in matters relating to her health and particularly with respect to any symptoms that may require diagnosis or medical attention.

 

What to Expect with Laparoscopy and Hysteroscopy

Laparoscopy is direct visualization of the peritoneal cavity, ovaries, outside of the tubes and uterus by using a laparoscope. The laparoscope is an instrument somewhat like a miniature telescope with a fiber optic system, which brings light into the abdomen. It is about as big around as a fountain pen and twice as long.

 

An instrument to move the uterus during surgery will be placed in the vagina. Carbon dioxide (CO2) is put into the abdomen through a special needle that is inserted just below the navel. This gas helps to separate the organs inside the abdominal cavity, making it easier for the physician to see the reproductive organs during laparoscopy. The gas is removed at the end of the procedure.

 

Hysteroscopy is direct visualization of the inside of the uterus.  The hysteroscope is an instrument somewhat like a miniature telescope with a fiber optic system, which brings light into the uterus.  This will allow your surgeon to look into your uterus and possibly remove abnormal tissue or growths.

Back to top

Prior to Surgery

• Use protection (barrier contraception “Condoms” and/or foam) during ovulation.  DO NOT GET PREGNANT the cycle of surgery.

• Arrangements should be made for child care outside the home for the day of surgery and possibly the next day. A quiet, restful environment is needed when you return home. Make arrangements for someone to be there with you for at least 48 hours after surgery. Expect your first night to be restless.

• You may wish to have the following items at hand to avoid having to send someone out after your surgery: prescription pain medication, heating pad, over-the-counter pain medications (Tylenol, Aleve, etc.), food (oatmeal, ice cream, rice, steamed vegetables, bread, fruit, yogurt, soup and saltine crackers may be easier on the stomach), thermometer, feminine pads, loose comfortable clothing to wear, throat lozenges, and a good book or video to watch while resting.

• Do not eat or drink anything after 12:00 midnight the night before surgery. Do not smoke or chew gum after 12:00 midnight. If you are currently taking medication, ask your doctor if you should stop taking it.

• Bowel Preparation: You may be given instructions regarding this during your pre-operative office visit. Bowel preparation is usually recommended for patients with endometriosis, pelvic adhesions or pelvic pain. Preparing the bowel with a purging agent such as Go-lytely,  Magnesium Citrate or Fleet Phospho-Soda may be advised.  While unpleasant, this procedure minimizes the risk of surgical complications from bowel injury during your surgery

• Contact the Anesthesia office regarding insurance prior to your admittance.

• Patient must shower or bathe the night prior to surgery, make sure your navel is very clean.

• Vaginal Prep: None is usually required

• Nail polish, make-up and jewelry should be removed the night before surgery.

• Wear loose-fitting clothes to prevent any unnecessary pressure on the umbilicus on the day of surgery.

• Someone must be with you to drive you home.  (It is nice to have a pillow in the car).

Back to top

In the Operating Room

•  The anesthesiologist or one of the nurses will walk you into the operating room

• The nurse anesthetist or anesthesiologist will place four adhesive tabs on your back or on your chest to monitor your heart rate. While watching the monitor, do not be alarmed about sudden changes in your heart rate or pattern. This may be caused by interference and are not related to your heart activity. You will be given medication that will make you drowsy and possibly make your vision blurry. Shortly after this, you will drift off to sleep.

Back to top

After Surgery

• After surgery, you will wake up in the recovery room. The nurse will check your blood pressure, pulse and temperature frequently. The nurse will check your dressing and intravenous. If you are cold, ask for an extra blanket. The nurse or physician will tell you when you will be allowed to drink something

• As soon as you are transferred from the Recovery Room (about one hour after surgery), you may have visitors. You may not remember conversations immediately after surgery, which is normal and lasts only a short period.

• Your physician will discuss the findings with your family immediately after the surgical procedure is complete. If your family leaves the waiting area please have them notify the receptionist regarding how they can be contacted.

•  Medication will be available for pain or nausea. Ask your nurse for this medication if you are uncomfortable. Medication will be in the form of injections until you are able to drink. Once you are able to drink, the doctor will change your medication to pills. Pain medication is usually allowed every 3-4 hours. Medication for nausea is usually allowed every 4-6 hours.  Do not take pain meds on an empty stomach it may cause nausea.  If the nausea persists let the doctor know and a different medication can be provided.  Rarely, a reaction will occur with the medication.  If you believe you are experiencing a reaction, stop taking the medication and call the office.  Do not take aspirin or products containing aspirin for the first three days following the surgery

• Sore Throat: You may experience a sore throat. This is caused by irritation from a tube placed in your throat (trachea) during anesthesia. It usually lasts for just a few days and can sometimes be helped by throat lozenges.

• You will remain in the surgery center for approximately three or four hours after the procedure. After you are able to empty your bladder, you will be allowed to go home. If additional medications are required, you will be given prescriptions to take with you. If you are unable to empty your bladder or nausea is severe, a 23 hour hospital stay over night may be considered.

Back to top

Care After Your Surgery At Home

•  Incisions - You will have a 1/2" incision just below your navel. This incision will have one suture which will dissolve. You will have 2 to 4 tiny (1/4") incisions near the pubic hair line. These incisions accommodate the instruments needed to perform the surgery. They may or may not have a suture. They will be covered with small strips of adhesive. These strips will fall off on there own.

• You may have drainage from these incisions for a day or two. It will be watery and pink-tinged. If needed, you may reinforce your dressings or change them if they become saturated. In most cases, this drainage lasts less than 48 hours. You may go without dressings 48 hours after surgery if you so desire. You may want to cover your incisions with a light dressing to protect your clothes or to prevent your clothing from rubbing on your incisions.  You should cleanse your incision with soap, water, and a Q-tip.  Blood clots in the incision may be removed, after they have dried, by swabbing with hydrogen peroxide.  A firm knot of tissue usually forms beneath the lower incision while it is healing.  This will vanish in approximately two month.  It is usual the have a bruised-like area below the incision in the navel, which will disappear in approximately two weeks.

• You may experience some cramping after surgery.  Light vaginal bleeding is to be expected.  Any unusual additional pain or bleeding should be reported.  Your next menstrual period may come sooner than expected or be different than usual.

•  Please call the office the day after surgery to let the nurse know how you are feeling and schedule a post-operative appointment in two weeks.

• If there are any problems at any time following surgery, do not hesitate to call the office Monday through Friday from 8:30am to 5:00pm.  For all other times, notify the answering service that you need to speak with the doctor on call.

Back to top

Diet

You may be given specific instructions regarding diet prior to leaving the hospital. In general, you must consume only clear liquids (juices, Jello, or both) until you pass gas from you rectum or have a bowel movement. At this time, you may begin to advance your diet. Eat light, easily digested food for a few days.

Back to top

Activity

• Expect to feel sore and "washed out" for a few days following surgery. Remember to get up and move about, even through you may not want to. Increase your activity gradually during this time. For a week or two after surgery expect to tire easily even after the slightest effort of work or exercise. Do not engage in strenuous activity until after your first post-op visit at our office. If you plan to travel, please check with your physician prior to surgery if possible. If an emergency arises and you must travel during the first week of surgery, please notify our office before you leave.

• The pain pills do what they are supposed to do, which is mask your pain. Therefore, you may feel a false sense of wellness due to the pain pills, so even though you feel fine the next day or two, be aware that your body is still recovering and take it easy. Eat and drink carefully. The last thing you will want to do following this type of surgery is choke or cough. Sneezing, laughing, crying and shivering from the cold may also be uncomfortable. So snuggle up and treat yourself well.

• The day following surgery, you may take a shower; however, do not take a bath for at least five days after surgery

 Back to top

Gas Pains

You may experience some gas pains from residual carbon dioxide that may remain in your abdomen following the procedure. This pain usually presents as shoulder pain or sharp pain underneath your diaphragm. The pain is usually transient and will disappear in a day or two. It helps if you get up and move around while you are having this pain, and also if you drink either hot water or hot tea with fresh lemon. Heat, massage and exercise can also help to alleviate this pain.

Back to top

Infection

Take your temperature every morning for one week. Please notify our office if your temperature is above 101 degrees. If you note increasing redness, swelling, pain or unusual drainage from your incisions, please call our office. If you experience frequent urination, burning with urination, or spasmatic pain in the lower abdomen above the pubic bone, you may have a bladder infection. Please notify our office if you have any of these symptoms.

Back to top

Sexual Activity

Sexual activity may be resumed approximately two to three days following surgery unless you are told otherwise. However, if you have any pain, vaginal bleeding, or discharge, please do not resume sexual intercourse until these symptoms have subsided.

Back to top