SURGICAL TREATMENTS OF ENDOMETRIOSIS: WHAT HAPPENS WITH A LAPAROTOMY
Precisely what will happen when you have your laparotomy will depend to some degree on what sort of surgery you are having, the practices of your gynecologist and the practices of the hospital. What follows should only be used as a guide.
You will probably be in hospital for about five to seven days if you are having a conservative laparotomy, or seven to ten days if you are having a hysterectomy.
You will usually be admitted to the hospital the day before the operation. After you have gone through the formalities of being admitted to the ward someone will probably take your medical history. A nurse will take and record your temperature, pulse, breathing rate and blood pressure. An electrocardiogram and blood and urine tests may be taken, particularly if you are having a hysterectomy. Your pubic hair and the lower part of your abdomen will usually be shaved and you may be given a suppository if you have not opened your bowels that day.
A physiotherapist may visit you and teach you some breathing and foot and leg exercises to do after the operation, especially if you are a smoker, an asthmatic or prone to chest infections.
The anesthetist will visit you to discuss the operation and ask you about any allergies and previous problems that you may have had with a general anesthetic, such as nausea.
Some time before your operation you will be given a consent form to sign so that you can give your permission to undergoing the operation. You may have previously signed the consent form when you discussed the operation with your gynecologist during an earlier visit.
At bedtime you may be offered a sleeping tablet to help you sleep in the unfamiliar hospital ward. It is important to have a good night’s sleep before your operation so it is advisable to take the sleeping tablet if it is offered.
You will not be allowed to have any food or drink for at least six hours before the operation. Shortly before the operation you will be asked to shower and put on a gown and you will be asked to empty your bladder. About an hour before you are due to go to the operating theatre you will probably be given an injection, known as a pre-med or a pre-medication, which will probably make you feel relaxed and sleepy and make your mouth dry.
If you are apprehensive about your surgery you may like to ask if you can have your partner or a friend or a close relative come to stay with you for the hour or two before you go into theatre.
Immediately before the operation you will be taken to the operating theatre. In the operating theatre an intravenous drip will be inserted into your arm and you will be given the general anesthetic. After you have lost consciousness a tube will be placed in your throat and connected to a machine that breathes for you.
A tube known as a catheter may be inserted into your bladder to drain the urine.
A horizontal cut about ten centimeters in length will usually be made across the abdomen along the pubic hairline. Sometimes the cut will be made vertically between the middle of the pubic hairline and the navel, particularly if you have previously had a vertical cut or if bowel surgery is likely.
The gynecologist will then thoroughly inspect the pelvic cavity for any signs of endometriosis, adhesions and other damage so that she or he can plan the operation and decide which procedures need to be carried out.
When the surgery has been completed the gynecologist will stitch up the wound and the tube in your throat will be removed. You will then be taken to the recovery room for about half an hour before being taken back to your bed in the ward.
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