Frequently Asked Questions
What is laparoscopy?
Laparoscopy is a surgical procedure under general anesthesia. Generally, a small incision is made in the belly button and the abdomen is filled with CO2 gas. This lifts the abdomen away from the internal organs, giving the surgeon a better view. The lighted laparoscope with a camera is then inserted into the abdomen. Three to four other small incisions may be made in the abdomen so additional surgical instruments can be used during the surgery.
During the laparoscopy, Dr Orbuch examines the pelvic organs, looking for obvious and atypical endometriosis lesions as well as endometriomas (endometriosis-filled cysts), adhesions, and scarring. Dr Orbuch performs a complete look at the entire abdomen to the pelvis. She looks at the diaphrogms, liver, gallbladder, appendix, small intestines, large intestines, ovaries, uterus, cul de sac, bladder and everywhere in between. Her abdominal and pelvic survey is very thorough leaving no stone unturned! Depending on your history and symptoms, the doctor may also look for fibroid tumors or other abnormalities. Other procedures, such as a hysteroscopy (an examination of the inside of the uterus) may also be performed.
Diagnosis and treatment of endometriosis takes place during the same procedure. All specimens for endomtriosis are EXCISED and will be sent to the lab for biopsy. This will document the presence or absence of endometriosis. If fibroids are removed they will also be sent to pathology. If an ovarian cyst is removed, it too will be sent to pathology. Dr Orbuch concludes the surgery with a cystoscopy to look in the bladder.
How long will I be in the hospital?
Laparoscopy is usually done on an outpatient basis (that means you go in the hospital the same day as the procedure and go home the same day too), although an overnight stay may be required if the surgery is complex or lengthy. If a bowel resection or partial bowel resection is performed, your hospital stay may be extended by several days. It’s a good idea to be mentally prepared to spend at least one night.
What if I am scared about surgery?
Almost everyone has some fears about surgery. We may worry about the risks, the anesthesia, the pain, or what the surgeon may (or may not) find. If you’re scared, it helps to determine what you’re afraid of, then work toward minimizing that particular fear. For example, if you’re afraid of the anesthesia, talk with your doctor and the anesthesiologist before the procedure to discuss your fears. If you are afraid of the pain, ask your doctor exactly how your pain will be managed. Many women have found that relaxation tapes before, and after surgery also help allay fears. Many of Dr Orbuchs patients do an extra yoga class the week before the surgery, or perform extra mindfulness the week prior to the procedure.
What should you take to the hospital?
Pack very loose clothing to wear after surgery, preferably something without a waistband. An oversized pullover dress is ideal. You may also want to take mini-pads as you may have some spotting post surgery, socks, and slip-on shoes. If there is a possibility you may be staying overnight, consider packing a hairbrush, lotion, bathrobe, toothbrush/toothpaste, and maybe a stuffed animal.
Will I have a bowel prep?
A bowel prep is usually done the day before surgery. The process varies, but usually includes a liquid diet and various preparations to evacuate your bowels. This is not a pleasant process, but it is necessary if any bowel work is anticipated. Women who suffer from constipation may find it helpful.
Will I have pain when I come out of surgery?
When you come out of the anesthesia in the recovery room, you may be in some pain. If so, be sure to speak up so your pain can be properly managed. Coming out from anesthesia will also make you feel cold. Ask for more warm blankets if you’re chilled. You may also have a sore throat from the tube that’s put in your throat during surgery. If any symptom becomes bothersome, tell the nurse or doctor.
Do I need someone to bring me home after surgery?
Even if your surgery is scheduled to be on an outpatient basis, you will be required to have someone drive you home. It’s a good idea to choose someone who is helpful and supportive and who can assist you into the house. If they can stay overnight in your home, even better. At least for the first evening, you will be groggy and may have some difficulty getting around.
I hear about shoulder pain after surgery, why is that?
One of the most disconcerting things about laparoscopy is the subsequent shoulder pain. This is caused by the CO2 gas becoming trapped against the diaphragm. (The gas irritates the phrenic nerve leading to referred pain in your shoulder). Heat and analgesics often bring relief. Be assured that time (usually 2-3 days) will take care of this pain. Heating pads placed on the shoulder can be very helpful.
Will I be nauseated after surgery?
It seems that most of us experience some nausea after laparoscopy. Many medications exist to help with this. Some can be taken before surgery, some during, and some after. Talk with your anesthesiologist beforehand about the methods they use to minimize nausea. Many women find that nausea is lessened when they lay flat. Some natural remedies, such as ginger tea, may also alleviate nausea. To be on the safe side, always ask your health care professional before taking any herbs or supplements. If you have undergone prior surgeries and were nauseated, please let your anesthesiologist know, and they will give you an extra anti-nausea medicine during the surgery. Most women find this very helpful.
What can’t I do post surgery?
No driving if you are taking narcotics. Intercourse, tub bathing, douching, and swimming will also be restricted post surgery (the length of restriction will depend upon the surgery you are undergoing). Don’t expect too much of yourself for the first few days. You will probably be very tired and need lots of naps. However, be sure to get up and move around as you’re able. You will recover more quickly if you move about.
I heard about Post-op blues. What are they?
Most of us experience a period of emotional ups and downs following surgery. For some, the blues remain for several weeks. It’s not unusual to cry easily or become anxious, agitated, frightened, or suspicious. All of this will pass in time and you will begin to feel in control again. Be gentle and patient with yourself during your physical and emotional recovery.
My incision is numb. Is that normal?
You may feel a “pins and needles” sensation at the incision site. This is due to the nerves being cut. Over time, the nerves will heal and the sensation will subside. If you have bothersome symptoms at the incision site, such as a knot, swelling, or redness, contact your doctor.
What kind of clothing should I wear after surgery?
Most of us have found that comfy clothes are very welcome during the first few weeks after laparoscopy. The incision site will be tender and the abdomen swollen. Therefore, you probably won’t want to wear anything snug around the middle.
Will my medical crazy glue fall off or do I pick it off?
Do not pick your medical crazy glue off. It will fall off on its own. For some women it takes a week or two, and for others 4 weeks. Be patient, it will fall off.
What should I expect regarding my first period post surgery?
Experiences with the first menstrual period vary dramatically. If your period is more painful, longer, or heavier than usual, don’t panic. Internal healing takes much longer than external healing. Therefore, your first few periods may be more painful. However, if you are concerned about the degree of pain, or if your pain is severe, contact your doctor.