Laparoscopy and Associated Treatment In Adolescence

Transcription

1 Rockingham Wing Laparoscopy and Associated Treatment In Adolescence Information leaflet for patients, parents and carers Information

2 Contents 1. Introduction 2. What is laparoscopy? 3. How is it done? 4. What tests are carried out before laparoscopy? 5. What type of anaesthetic will be administered? 6. What are the benefits and complications of laparoscopy? 7. What alternative treatments are available? 8. What preparation will be required before the operation? 9. How long will my child need to stay in hospital? 10. What care will be needed after laparoscopy? 11. When should we seek hospital advice? 12. Will my child need to visit the hospital again after the operation? 13. Contact Numbers 14. Sources and acknowledgements 2

3 1. Introduction The specialist has recommended an operation which is usually done to determine what is causing tummy (abdominal) pain. This operation is called a laparoscopy. This can tell us the cause of the problem and can also be used to treat any abnormal findings, some of which you will find listed below. 2. What is laparoscopy? A laparoscopy is a procedure that allows the doctor to look inside the tummy (abdomen) and determine the reason for the problem. This is performed under a general anaesthetic which means that the patient will be asleep during the procedure. 3. How is it done? Small cuts (incisions) measuring around 1-2 cm, are made in the abdomen and special laparoscopic instruments are inserted through these. Usually two small cuts are made, one just below the belly button and one on the hairline (suprapubic). Alternatively they may be one or other sides of the tummy. The abdomen is first inflated with gas (carbon dioxide) and a laparoscope (which is an operating telescope) is inserted through the belly button cut. The laparoscope has a viewing lens on one end and camera on the other which takes images and/or videos and displays the appearances on the screen for the doctors to have a clear view of what is happening in the tummy. Typically the operation lasts around minutes. 1 The laparoscopy is performed to identify and treat certain conditions, such as removal of cysts on the ovaries. It also helps 3

4 the operator to see the bowel, appendix, gall bladder and liver, which may also cause abdominal pain What tests are carried out before laparoscopy? Your doctor might request an ultrasound scan of your abdomen to allow for a better understanding of the problem. This is a simple, non-invasive and pain free test. There will be blood tests which are routine and are done on every patient undergoing surgery. In some cases the doctor might request a more detailed scan (CT, MRI) to gain more information about organs in the abdomen before proceeding to invasive surgery. There will usually be a pre-operative assessment and a separate appointment will be sent prior to the operation. Please do ask the nurse if you are not sure about anything. 5. What type of anaesthesia will be administered? Usually this procedure is performed under general anaesthetic which means you will be put to sleep. 6. What are the benefits and complications of laparoscopy? Benefits: The main aim of doing this operation is to find the cause of the problem and treat it. 4

5 Complications: The main risks include bleeding, infection, and damage to bladder, bowel and blood vessels. 3 If any damage does occur, it will be repaired at the time of laparoscopy. However, this might mean a longer stay in hospital and probably a bigger cut in the abdomen. There is a small possibility that the treatment required cannot be performed using laparoscopy, and in such a situation the doctor might open up the abdomen. This will be discussed with you and your child before the operation. There are also risks associated with the anaesthetic but you will have an opportunity to discuss this with the anaesthetist before the operation. 7. What alternative treatments are available? Alternative treatments are usually discussed during the clinic consultation. However, if you or your child are not certain about anything or this was not discussed, please do not hesitate to ask. 8. What preparation will be required before the operation? For a morning list, there should be nothing to eat or drink from 12 midnight. For an afternoon list, take a light breakfast no later than 7am then nothing after that. If regular medication is being taken then this should be taken with sips of water only. You will need to pack a small bag with a dressing gown and slippers, all the medication including inhalers, toiletries and towel as well as an emergency contact numbers. 1 5

6 It is important not to have any chewing gum or sweets before the operation as this may lead to cancellation of the operation How long will it be necessary to stay in hospital? Laparoscopy is a day case procedure we anticipate discharge home the same day. There will need to be a responsible adult to provide company for at least the next 24 hours as there may have some residual anaesthetic effects. If there is a need to stay in the hospital overnight a parent or carer may be able to stay. A parent or carer may also be able to travel to the operating theatre and return to the recovery area. 10. What care will be needed after laparoscopy? Stitches: There will usually be a few stitches which are dissolvable. Please keep any dressing clean and dry for 2 days after which you can remove the dressing and bathe the area as usual. 1 Please do not rub the area as it can cause irritation. Also avoid putting any cream or talcum powder onto the wound. Stitches may take a few weeks to dissolve. If after 2 weeks they cause discomfort, please go to your GP s surgery and ask the practice nurse to remove them. 1 Pain/discomfort: Experiencing pain or discomfort in the first few days is quite common. Please ensure you take a regular painkiller, such as Paracetamol, for the first few days after the operation. If, however, the pain gets worse or does not settle after taking painkillers, please contact the ward. Your child will need 1-2 weeks off from school or college. Your hospital consultant or GP will be able to provide a sick note for the child. 6

7 11. When should we seek hospital advice? It is quite common to have shoulder tip pain or upper abdominal discomfort after the operation. Most laparoscopic procedures do not cause any problem afterwards, but there are certain signs you will need to look out for at home: If there is a raised temperature, redness around the stitches or discharge, infection is a possibility. If this happens seek advice from your doctor. Bleeding is another complication after this operation. This does not usually happen following discharge but if you feel or appear unwell or pale, seek advice immediately. Injury to bowel is another rare complication of this operation. Normally it is identified during the operation and repaired. However, sometimes it can go unnoticed. If your child has persistent or increasing abdominal pain or vomiting, contact the hospital immediately. 12. Will my child need to visit the hospital again after the operation? Your doctor will tell you after the operation if there is a need for a hospital appointment. If so, then you will get an appointment letter through the post 7

8 13. Contact Information For further advice or information, please contact NHS Direct Online ( Your local pharmacist Out of these hours Out of these hours, please contact your GP or the emergency services If you need this information in another format or language, please telephone Further information about the Trust is available on the following websites: KGH - NHS Choices - Ref: PI.273 May 2013 Review: February 2015