What are the benefits of laparoscopy? What are the benefits of laparoscopy? What are the risks of laparoscopic surgery? What are possible complications following laparoscopic surgery? Wound infection Bruising Hematoma formation Anesthesia-related complications Injury to blood vessels of the abdominal wall or those of the lower abdomen and pelvic sidewall. Injury to the urinary tract or the bowel What can I expect immediately following laparoscopic surgery? Nausea and lightheadedness Scratchy throat if a breathing tube was used during the general anesthesia Pain around the incisions Abdominal pain or uterine cramping Shoulder tip pain-secondary to the carbon dioxide gas Tender umbilicus (belly-button) Gassy or bloated feeling Vaginal bleeding or discharge (like a menstrual flow) What is the normal recovery time following laparoscopic surgery? When should you contact the physician after laparoscopy? Heavy bleeding from the incisions Fever or chills Problems with urination or bowel movements Heavy vaginal bleeding Severe or increasing abdominal pain Vomiting Redness or discharge from the skin incisions Shortness of breath or chest pain Will I have a catheter in my bladder at laparoscopic surgery? Can I have other surgery performed at the time of my laparoscopy? What is endometriosis and how is it diagnosed? How is endometriosis treated? Can endometriosis be treated laparoscopically? What is the treatment for ovarian cyst? What are fibroids? Can I have my fibroids removed laparoscopically (myomectomy) rather then having a hysterectomy? Can I have my fibroids removed laparoscopically if they are located inside the uterus (submucosal)? If I would like my uterus removed laparoscopically is this always an option? Does my cervix have to be removed at the time of my hysterectomy? Why would I consider a subtotal hysterectomy rather then a total hysterectomy? What are the other alternatives to hysterectomy?
What are the risks of laparoscopic surgery?
What are possible complications following laparoscopic surgery?
What can I expect immediately following laparoscopic surgery?
What is the normal recovery time following laparoscopic surgery?
When should you contact the physician after laparoscopy?
Can I have other surgery performed at the time of my laparoscopy?
Will I have a catheter in my bladder at laparoscopic surgery?
What is endometriosis and how is it diagnosed?
How is endometriosis treated?
Can endometriosis be treated laparoscopically?
What is the treatment for ovarian cyst?
What are fibroids?
Can I have my fibroids removed laparoscopically (myomectomy) rather then having a hysterectomy?
Can I have my fibroids removed laparoscopically if they are located inside the uterus (submucosal)?
If I would like my uterus removed laparoscopically is this always an option?
Does my cervix have to be removed at the time of my hysterectomy?
Why would I consider a subtotal hysterectomy rather then a total hysterectomy?
What are the other alternatives to hysterectomy?
The recovery time in the immediate post operative period is quicker. Patients often go home after only 23 hours to recover in the comfort of their own home. The small incisions tend to be less painful and patients often need less postoperative pain medication as a result. Fewer wound infections occur. The cosmetic results are also appealing as the scar is limited to three or four skin incisions that are less then one half inch long.
The risks are similar for both laparoscopic and open surgery. First and foremost, there is always the possibility that surgeon may not be able to complete the procedure laparoscopically. This may be secondary to unexpected complications or because the surgery cannot be safely performed with a laparoscopic approach. Complications specific to laparoscopy include injury to the bowel, bladder and blood vessels at the time of insertion of the surgical instruments and hernia formation at an incision site. Other complications not specific to laparoscopy include infection, bleeding and deep vein thrombosis (blood clot in the legs). Death is also a potential but RARE complication of any type of surgery.
Generally, you may experience any of the following symptoms within the first twenty-four to forty-eight hours
Recovery depends on the type of procedure you had performed. Most patients feel well within days of surgery. But if major surgery has been performed rest is still required. Most patients will require some form of pain medicine in the immediate postoperative period. A prescription for a narcotic as well as an anti-inflammatory, will be provided prior to discharge. Avoidance of heavy lifting (greater then 10 pounds), jumping and jogging is recommended until 4 weeks postoperatively. Sexual intercourse should also be postponed for 4 weeks. It is preferable not to put anything into the vagina for at least 4 weeks including tampons. The timing for returning to work depends on the procedure performed. Most patients who undergo an ovarian cystectomy or ectopic pregnancy are ready to return to work within 2 weeks. If a hysterectomy is performed, 4 to 6 weeks off work is recommended. The doctor will discuss this with you after surgery and help you make an informed choice.
You should not hesitate to call the doctor if you develop any of the following symptoms:
Most patients have a catheter inserted at the time of surgery. This catheter is removed in the operating room or within 6 to 12 hours after surgery. Occasionally, the catheter must be reinserted because the patient is unable to void. If this occurs the catheter is usually removed 24 hours later to give the bladder a chance to recover.
Yes. Occasionally two procedures are scheduled at the same time. Hysteroscopy is frequently performed at the same time as laparoscopy. Women may also elect to have another elective surgery performed in combination with their gynecologic procedure. Surgeries that have been performed concurrently have included liposuction, gallbladder removal and breast implants.
Endometriosis is a condition, when the endometrium (the lining of the uterus) is found in other places than the uterine cavity. Endometriotic implants can be found on pelvic sidewall, fallopian tubes, ovaries, bowel, bladder, and less commonly outside of the pelvic cavity. Like the endometrial lining in the uterus, these implants undergo similar changes in response to the cyclic hormonal changes. The implants may swell and bleed every month causing pain. Endometriosis may also lead to cysts and adhesions. This condition is found in approximately 20% of women. The most common symptoms of endometriosis are pain with your period, irregular bleeding and infertility. At the present time there is no simple test for diagnosing endometriosis. The only way to diagnose endometriosis with certainty is by laparoscopy and biopsy. Rarely large endometriotic lesions can be diagnosed by ultrasound.
Endometriosis can be treated with medications, surgical excision, or combination of the two methods. You should discuss the treatment options with your gynecologist.
Yes. A laparoscopic biopsy is required to diagnose endometriosis. Endometriotic implants can also be treated laparoscopically with excision or burning. This treatment usually produces more immediate results in terms of pain relief and fertility compared to medical therapy.
A cyst is a fluid filled cavity. Cysts can often be found in the ovaries. Ovarian cysts are usually diagnosed by pelvic exam or ultrasound. If the cyst is entirely filled with fluid it is called a "simple cyst". Ovarian follicles as they undergo maturation may appear on ultrasound as simple cysts or occasionally as complex cysts. These cysts usually resolve within one to two months. Simple cysts are almost always benign. Removal is indicated if they are bigger than 5-6 cm in diameter or if they cause symptoms. If the cyst contains echogenic structures (shadows by ultrasound) it is categorized as a "complex cyst". Complex cysts can represent endometriosis, infection, benign tumors, and rarely malignancies. It is generally recommended that complex cysts be evaluated laparoscopically and possibly removed. The majority of ovarian cysts can be removed laparoscopically.
Fibroids are benign growths of the uterus. They occur in 20 to 25 percent of women. Fibroids are most common in women aged 30 to 40 but may occur at any age. Women may have one fibroid or many fibroids. The size of the fibroid also varies from the size of a small pee to more then 6 inches wide.. Some women may be entirely asymptomatic and others may complain of changes in menstruation, pain, pressure, miscarriages and infertility.
Yes. Some women may have their fibroids (benign growths on the uterus) excised laparoscopically. This procedure is limited to fibroids that are on the outside of the uterus (Pedunculated) or just under the uterine wall (subserosal). Fibroids that are buried deep in the uterus cannot be removed with this approach. The fibroids are then morcellated (ground) and removed through the small incisions. Occasionally, with resection of a fibroid, the uterine cavity may be entered and suturing is required. This usually can be performed using special laparoscopic instruments but infrequently a small ("mini") pfannensteil ("bikini") incision is made to repair the uterus. Rarely a hysterectomy must be performed because of heavy bleeding or inability to reconstruct the uterus. Sometimes a drug (GnRH agonist) may be used to shrink the fibroid and control bleeding prior to surgery.
No. If the fibroids (benign growths on the uterus) are only in the inside of the uterus they cannot be approached laparoscopically. Rather, your physician may recommend a hysteroscopic approach.
In most cases the uterus can be safely removed laparoscopically. This is not an option when the uterus is very large (greater then 18 week pregnancy in size). Recovery after laparoscopic hysterectomy is usually quicker than after abdominal hysterectomy. To help you choose the most suitable and safe surgery the doctor will consider all these factors prior to proceeding with a laparoscopic hysterectomy.
No, some women elect to have a subtotal hysterectomy. This simply means that the fundus of the uterus is removed and the cervix is maintained. The uterus is removed with the help of a morcelator (a grinder). This instrument allows the surgeon to remove large uteri through small incisions. Not all women are candidates for a subtotal hysterectomy. A previous history of abnormal pap smears would be a contraindication to this approach. To help you choose the most suitable and safe procedure the doctor will consider all these factors prior to proceeding with a subtotal hysterectomy. All women who undergo a subtotal hysterectomy must still have pap smears performed yearly.
This procedure is often faster, associated with fewer surgical complications and more rapid return to normal activities. There is also some evidence to suggest that there is less disruption of the pelvic floor and, therefore, less pelvic prolapse requiring additional surgery in the future. The cervix may also play a role in female orgasm. Many women request a subtotal hysterectomy in order to retain their cervix for sexual function. It is important to realize, however, that just as many women who have had a total hysterectomy have very normal sexual function.
Depending upon your symptoms, there are several different alternatives to hysterectomy. Majority of hysterectomies are performed either doe to abnormal bleeding or fibroids. If you have irregular bleeding and your uterus is not to big, endometrial ablation (destruction of the endometrial lining) can be viable option to hysterectomy (look up section under hysteroscopy). If you have fibroids, a myomectomy (removal of fibroids) may be viable treatment for you. If you have large uterine fibroid, uterine artery embolization may be an alternative to hysterectomy. You should discuss all those issues with your Gynecologist before you decide to have the hysterectomy.
Frequently Asked Questions on Laparoscopy & Hysteroscopy
By Reprinted with Permission of Gynlaparoscopy.com
The site of Resad Pasic, MD, PhD OBGYN.net Editorial Advisor |
June 21, 2011
|
TopicIndex
MedicaForums
Medica Forums -
5/23/13
Hello,
Has anyone tried FetalGrowth app (App Store for iPhone/iPad) ? I'm interested in using a simple and handy tool to calculate fetal percentiles, and I came across this app, which seems it does the job (plots growth charts, as well). I haven't seen anything else, besides this app, so I was wondering if there are people who have already tried it. Thanks !
Medica Forums -
5/19/13
Had a case the other day with the above finding on a pap. She was age 36 and had a Mirena in place. How do people feel about the idea of trying to do an EMB with an IUD in place? If not, how do we proceed?
Medica Forums -
5/12/13
Welcome to the new ObGyn.net Forum!
To all the members of OB-GYN-L… Thank you for coming! I’m thrilled that you’ve decided to check out the new Forum site, and look forward to reading about what’s on your mind. If you’re new to the ObGyn.net community... welcome aboard! You’ve just joined an outstanding group of physicians and health care professionals who have been sharing information, answering questions, and building professional relationships via the site’s listserv for nearly 20 years. Feel free to poke around on the site to get a feel for things, or take a look at the Help Topics page for instructions on how to use the different features of the site. A few quick tips: For those of you who like getting new Forum messages delivered directly to your inbox, the first thing you’ll want to do is click on the ‘Follow this forum’ button on the main page. You’ll have the option of getting notifications immediately, as a daily digest, a weekly digest, or only when you’re not online (which is to say, if you’re on the site when someone posts a message, you won’t be notified of it). You won’t be able to post on the site just by replying to the email, but the message will contain a link that takes you directly to the message you’d like to reply to. You can also follow individual conversations without following the whole list by going into the topic and clicking the ‘Follow this topic’ button next to the title. Also, in ‘My Profile’ you can:
Happy posting!
Medica Forums -
5/11/13
I helped another physician with removal of a retained placenta last night, we were unsuccessful in removing it vaginally, her cervix was too closed to allow manual removal and we could only get a few pieces out with ring forceps and a large curette, so we did a laparotomy/hysterotomy and were able to preserve the uterus. The placenta turned out not to be an accreta and it was easily removed via that route through a low vertical incision on the uterus. Any thoughts on the appropriate CPT code would be appreciated. The patient came in through the ER five days after home delivery by her husband. She was severely anemic, rcvd 7 units of blood and is still quite ill and in the ICU but improving.
Ronald E. Ainsworth, MD, FACOG
Medica Forums -
4/15/13
Recently, I had the occasion to review a case of a term primigravida with PROM in a private hospital (no housestaff or in house obstetricians). She was seen by an obstetrician soon after arrival, evaluated, and pitocin induction begun.
She did not deliver for around 29 hours after admission, and the delivering obstetrician (a different physician) was physically present during the last 2 hours of labor prior to delivery. Simply put, while the two involved obstetricians were in communication by phone with the nursing staff throughout labor (separately as their "shifts" did not overlap), no one actually came to the bedside and wrote a note) from admission until around 2 hours before delivery. Medical staff bylaws call for a daily progress note; this bylaw was easily met. In reviewing the case, it did not "feel good" that no one came to the bedside. My questions: 1. Does anyone have or know of any guidelines to mandate such bedside attendance? Of course, we all hope that the involved physicians would not need said guidelines. 2. Does anyone have a suggestion of hospital/nursing protocols? Simply, in this case I would like to have had a charge nurse or bedside nurse simply say, "Hey, no one has been by for a while. What's up?" Garry
Medica Forums -
4/12/13
Hey, what textbooks would you advise for my son who is beginning residency this summer?
Post here or email privately if better. Thanks, Garry
Medica Forums -
4/8/13
<p>Hello friends ,
I want to know how much does a facelift cost on average? Do you know anyone what is facelift cost ? please help me .........
Medica Forums -
4/7/13
Hello,
I really need help from OB/GYNs and I'm having a hard time getting it. I find your opinions really valuable. I'm researching recommendations for cosleeping. This is for my dissertation, so your time is truly appreciated! Please complete the full survey. It will help me tremendously. The study takes about 5 to 10 minutes to complete. Please don't hesitate to contact me at bhamel@pacificu.edu with any questions. If you are interested in participating, please follow the link provided below: https://www.surveymonkey.com/s/Cosleeping Thank you in advance for your time. If possible, please forward this to other OB/GYNs you know. Sorry if this an innappropriate use of the forum. But it seems like the right place to find the participants I need.
Medica Forums -
4/7/13
.
Our hospital bought an electronic medical record (EMR) system for the clinics. There is a large hosptial group practice including pediatrics, medicine, FP, OB/GYN, and other specialities and sub-specialities. Furthermore, the hospitalists and the ER doctors are also employed in the same hosptial group practice. The hospital spent millions of dollars on an EMR. As best I can tell there are only two useful things that the EMR does. One is to automatically calcualte the BMI, which it does very well. THe other is to make records available on any patient to any doctor anywhere in the practice. It does not do this well -- it requires lots of mouse movements and clicks and different documents come up in different formats, making it labor intenisve. But, with enough time, effort, and frustration, one can obtain copies of every document in the sustem, either on a computer screen or on paper. Swith to the ER now. A paitnet whom I had seen the previous week in consultatio comes into the ER for a non-pregnancy problem. They call me on the telephone in the evening. "No problem", I say. I did a torough evaluation and wrote a detailed note on the patient and her OB and non-OB problems only a few days ago. "Just go to the EMR and you can print out my note with all the details." Seems, however, that for some reason the EMR is not available in the ER (or on the wards for that matter). When I asked the hosptial administrator about it the next morning, he said that he and the hosptial lawyers were working on the problem. Apparently the government thinks that the ER doctors and hospitalists have nothing better to do with their time than to print out copies of patients' medical records from the EMR and sell them on the black market. Therefore, we cannot let those nasty doctors have access to the EMR records. Nevermind that the ER doctors are in the same group practice as all the other doctors. Never mind that the patient is willing to sign a release so that the doctor who is taking care of her can see the records of the practice. We have to protect the patient even if it means that vital information is rendered unavailable and that things are made more difficult, complicated, and expensive. It reminds me of the Army in Viet Nam where they would have to "destroy a village in order to save it!" Apparently the EMR makes us destroy a patient in order to save her. Thank GOD for the EMR. Three million dollars and the only benefit is that we can get a BMI 10 seconds faster. I think the NEJM got it correct last month when they said in an atricle that the only ones who truly benefit from electronic medical record systems are the people who make and sell them. Dean Huffman
Medica Forums -
4/7/13
Decline in Semen Concentration and Morphology in a Sample of 26,609 Men Close to General Population Between 1989 and 2005 in France
http://www.medscape....22498EV&spon=16 EducationalTutorialsEducational Tutorial: Complications of Laparoscopy
February 7, 2012 There are a variety of complications that can occur during laparoscopic surgery. In this tutorial learn some of the complications and tips to avoid them. Educational Tutorial: Low Molecular Weight Heparin in Recurrent Abortions
January 17, 2012 Review information on low molecular weight heparin in recurrent miscarriages in this educational tutorial. CaseStudiesFetal Abdomen with Gallbladder Calculi
Dr. Muktachand and Dr. Trupti , September 27, 2011
Sacrococcygeal Teratoma?
Dr. Jaydeep , September 14, 2011
Fetal Cardiac Anomalies
Joshua Abbott Copel, MD OBGYN.net Advisory Board Member , July 19, 2011
Single Umbilical Artery Color Doppler
Abana Cerekja , June 15, 2011
FromPhysiciansPracticeFive Steps to Improving Patient Access Judy Capko, May 21, 2013 Patient access is getting increased attention through reform initiatives. Here are five steps you can take to make sure patients get appropriate access to care in your office. Growing HIPAA Threat – Ignore Windows XP at Your Own Peril Marion K. Jenkins, May 21, 2013 Chances are good that you have some major ticking software time bombs lurking in your medical practice's computer environment, namely Windows XP and Server 2003. Finding Physician Work-Life Balance in the Small Moments Jennifer Frank, MD, May 21, 2013 At my practice and at home, things are always busy. There's laundry or homework, or a patient with needs. Three Areas to Reduce Costs at Your Medical Practice Greg Mertz, May 19, 2013 By taking a hard look at reducing costs for staffing, overhead, and technology at your medical practice, you may see increased physician compensation. Dos and Don’ts for Starting a Physician Blog Michael Woo-Ming, MD, May 18, 2013 Starting a physician blog can provide your medical practice with marketing benefits, but it's important to do it right.
MostPopular
MostPopular
MostPopular
Comments
Comments
SearchMedicaSearchResultFind peer-reviewed literature and websites for practicing medical professionals EventCalendar
|
B mode and 3D Ultrasound images of a fetal abdomen (35wks) revealing gallbladder calculi
This case study shows a 26 week gestation with a cystic mass close to the sacrum.
CC is a 31 year old primigravida who was referred for ultrasound at a community hospital due to suspected cardiac anomalies noted on a screening sonogram at her doctor's office. Due to concern about a probable cardiac abnormality an amniocentesis was performed at the local hospital.
Single umbilical artery color doppler, transverse scan of urinary bladder shows single umbilical artery (left), transverse section of umbilical cord showing only two vessels: one vein and one artery (right).
Normal 35 week pregnancy
CancerNetwork |
ConsultantLive |
Diagnostic Imaging |
Musculoskeletal Network |
OBGYN.net |
PediatricsConsultantLive |
Physicians Practice | Psychiatric Times | SearchMedica | Medical Resources
Physicians Practice | Psychiatric Times | SearchMedica | Medical Resources
© 1996 - 2013 UBM Medica LLC, a
UBM company
Privacy Statement -
Terms of Service -
Advertising Information -
Editorial Policy Statement -
UBM Medica Network Privacy Policy