Preparing for Surgery in Pottstown & East Norriton, PA
Why is surgery used?
- Abnormal Uterine Bleeding
- Abdominal Hysterectomy
- Infection in the ovary or tubes
- Endometrial Hyperplasia (Overgrowth of tissue in the lining of the uterus)
- Pelvic Pain
What is your planned surgery?
- Total Laparoscopic Hysteroscopy
- Diagnostic/Operative Laparoscopy
- Laparoscopic Tubal Ligation
How do I prepare for surgery?
- Before surgery, you will have a pre-op appointment with your doctor to discuss the planned procedure
- You will then meet with the Surgical Coordinator who will work with you and your insurance company to facilitate scheduling your surgery.
- Depending on your health, we may ask that you see your primary doctor or another specialist to make sure you are healthy for surgery.
- The Surgery Coordinator will arrange an appointment at the hospital where the surgery will take place for pre- admission testing. This is when you meet the Anesthesiologist and get all required labs and studies performed ie. chest xray, EKG etc.
- Some medications may need to be stopped before the surgery
- Smoking can affect your surgery and recovery. Smokers may have difficulty breathing during the surgery and tend to heal more slowly after the surgery. We advise that you quit 6-8 weeks before surgery. If you are unable to quit, your doctor can order a nicotine patch while you are in the hospital.
- You will need to complete a bowel prep 24 hours before the surgery. You will receive the instructions for this from the Surgical Coordinator at the pre-operative appointment.
- Remove all body piercings and acrylic nails.
- If you have a “Living Will” or an “Advanced Directive” , bring a copy to the hospital on the day of surgery.
- Most women recover and are back to routine activities within 4-6 weeks. You may need a family member or a friend to help with your day to day activities for the first few days after the surgery.
What can I expect during the surgery?
- Once in the operating room, you will receive either heavy sedation if you are have a hysteroscopy and general anesthesia for laparoscopic procedures.
- If you receive general anesthesia, after you are asleep and before surgery begins:>
- A tube to help you to breathe will be placed in your throat
- A catheter will be inserted into your bladder to drain urine
- Compression stockings will be placed on your legs to prevent blood clots
- After you are asleep the laparoscope is inserted into the abdomen and carbon gas is blown into the abdomen to inflate the belly wall.
- The doctor will remove the uterus cervix, tubes and possibly the ovaries through 4 small abdominal incisions. The vaginal incision is then closed with several stitches. Photographs will be obtained for your medical record.
- After you are asleep the hysteroscope is inserted into the uterus and saline fluid is infused into the uterus to distend the uterine cavity.
- The doctor will inspect the inside of the uterus will remove or simply biopsy any abnormal findings. Photographs will be obtained for your medical record.
- HYSTEROSCOPY w/NOVASURE:
- After completion of the hysteroscopy, the Novasure device is inserted and the ablation procedure is performed.
- HYSTEROSCOPY w/MYOSURE:
- After completion of the hysteroscopy the Myosure device is inserted into the uterus and is used to remove and grind up polyps or small fibroids.
Although there can be problems that can result from any surgery, we work very carefully to ensure the procedure is performed as safe as possible. However, problems can occur even when things go as planned. You should be informed of these possible problems, how often they happen, and what will be done to correct them.
Possible risks during surgery include:
- Bleeding: If there is excessive bleeding, you may need to receive a blood transfusion. If you have personal or religious reasons for not wanting a transfusion, you must discuss this with your doctor prior to surgery.
- Damage to the bladder, ureters (tubes that drain the kidneys into the bladder), and the bowel: damage occurs less than 1% of surgeries. If there is damage to any of these organs it will be repaired during the surgery.
- Conversion to an open surgery requiring a bikini or up & down incision: if a larger incision is required, you may need to stay in the hospital longer.
- Death: All surgeries have a risk of death.
Possible risks that can occur days to weeks after surgery:
- Blood clots in the legs or lungs: Swelling or pain, shortness of breath or chest pain are signs of blood clots.
- Bowel obstruction: A blockage in the bowel that causes abdominal pain, bloating, nausea and/or vomiting.
- Hernia: Weakness in the muscle at the incision that causes a lump under the skin.
- Incision opens: The abdominal skin or the vaginal incision.
- Infection: Bladder or surgical site infection. This may cause fever, redness, swelling or pain.
- Scar tissue: Thicker tissue that forms at the site of surgery. This can cause pain or discomfort in later years after surgery.
What happens after the surgery?
- You will be monitored in the recovery room for approximately one hour before being transported to your room.
- You will be started on a liquid diet a few hours after surgery. When you are feeling better you may return to regular diet.
- You may have cramping, feel bloated or shoulder pain
- You may have a scratchy or sore throat from the tube used for your anesthesia.
- You will be given medication for pain and nausea if needed
- You will have compression stockings on your legs to improve circulation
- You will start walking as soon as possible to help healing and recovery
- You will stay in the hospital for 23 hours with expected discharge around noon-time the following day.
At home after surgery
Call your doctor right away if you:
- Develop a fever higher than 100.4 (38C)
- Start bleeding like a menstrual period requiring a pad every hour
- Have severe pain in your abdomen or pelvis that is not improved with the pain medication
- Have persistent nausea and vomiting
- Have chest pain or difficulty breathing
- Leak fluid or blood from the incision or if the incision opens
- Develop swelling, redness or pain in either of your legs
- Develop a rash
- Have pain with urination
Caring for your incision
- Your incision is closed with a single clear non-absorbable suture that will need to be removed 7-10 days after surgery; you will need to call to schedule that appointment
- Clean with warm soap and water, pat dry or you may use hair dryer on warm setting
- Remove any band aids or any other adhesive dressing within 72 hours.
- Spotting is normal.
- Discharge will change to a brownish color followed by a yellow cream color that can last for up to 4-8 weeks.
- It is common for the brownish discharge to have a slight odor because it is old blood.
- Pain: medication will be prescribed for you after surgery. Do not take it more frequently than instructed. If you require additional pain medication after completing what was dispensed, you will be required to come into the office to be evaluated for persistent pain.
- Stool softener: Narcotic pain medications may cause constipation. A stool softener may be needed while taking these medications.
- Nausea: Anti-nausea medication will be prescribed only in certain circumstances ie if you have a history of nausea with general anesthesia.
- Gas/bloating: you may obtain Simethicone (Gas-X) which can be found over the counter and take as directed.
- You will resume your regular diet.
- If you are nauseated or excessively bloated, avoid high fiber foods for the first 2-3 days.
- Energy level: It is normal to have decreased energy level after surgery. During the first week at home, you should minimize any strenuous activity. Walking around the house and taking short walks outside can help you get back to your normal energy level more quickly
- Showers: Showers are allowed within 24 hours after your surgery.
- Climbing stairs: Climbing stairs is permitted, but you may require some assistance when you first return home; take one stair at a time and you may consider using a “hug-me” pillow.
- Lifting: you should not lift anything heavier than a gallon of milk for 4-6 weeks after your surgery. This includes pushing objects such as a vacuum cleaner. No vigorous exercise during this time.
- Driving: You are not permitted to drive during the time that you are taking the prescribed Narcotic pain medication. You may resume driving in 1 week as long as you are not in discomfort which would inhibit your ability to make sudden movements.
- Exercise: Exercise is important for your health and wellness. Start with short walks and gradually increase the distance and duration. To allow for adequate time to heal, you should not return to a vigorous exercise program until between 4-6 weeks after surgery. It may take a few weeks to build up your stamina.
- Intercourse: No vaginal sex for 6 weeks after surgery and only after your doctor has completed a post-operative pelvic exam.
- Work: most patients return to work within 4 weeks after surgery. You may continue to feel tired for a couple of weeks.
Follow up with your doctor:
You should have the first post-operative appointment scheduled for 7-10 days for suture removal. You will have another post –operative exam 6 weeks after your surgery.