Laparoscopically Assisted Vaginal Hysterectomy

Transcription

1 Laparoscopically Assisted Vaginal Hysterectomy Families Division Patient Information Leaflet Options available If you d like a large print, audio, Braille or a translated version of this leaflet then please call: Our Four Values: People Centred Positive Compassion Excellence

2 What is Laparoscopically Assisted Vaginal Hysterectomy? This is removal of the uterus through the vagina with key-hole surgery assistance through tiny cuts on your abdomen. i.e. some of the procedure is performed through the vagina. The fallopian tubes and ovaries may also be removed at the same time (this will be discussed with you before the operation). What will happen before the operation? You will be seen in the pre-operative assessment clinic a few days before the operation. Usually you will be admitted to the ward on the morning of the operation. You must not eat or drink anything after midnight the night before the operation. What will happen during surgery? After you have had your general anaesthetic, a telescope and other instruments are passed through small cuts made in your abdomen which will be inflated with Carbon Dioxide gas to enable the surgeons to see and perform the procedure. The incisions will be sutured with dissolvable stitches and covered by dressings. The remainder of the procedure will be done vaginally and your womb, with or without your fallopian tubes and ovaries, will be removed vaginally as well. Then the vaginal incision will be closed using dissolvable sutures. Are there any complications? Anaesthetic complications are generally very rare and will be discussed with you by the anaesthetist.

3 Potential complications of the procedure are generally rare and include bleeding, injury to major blood vessels, injury to the bladder or ureter, bowel injury, infection, blood clots in the legs or the lungs. Sometimes a larger incision may be required to repair some of these complications. This is called laparotomy. There is a risk that the operation might not be possible to be done laparoscopically with the need to revert to abdominal hysterectomy. This can be due to problem with access, a lot of scar tissue inside the abdomen and pelvis and excessive bleeding during the operation. Less serious complications include escape of some of the carbon Dioxide gas under the skin, which will resolve itself. Precautions are routinely taken to avoid these risks. What might I expect when I wake up? You will be taken to the recovery area where the trained staff will monitor your pain, nausea and check other observations. You will have a urinary catheter to empty your bladder. You may also have some vaginal bleeding so a sanitary pad is provided. You may have a vaginal pack which is soaked in an antiseptic solution. This pack and the catheter are usually removed within 12 hours after surgery. What might I expect after surgery? You may experience some shoulder pain / discomfort caused by trapped gas inside your abdomen. These usually settle down quickly but pain relief, peppermint water and mobilisation will be helpful. After you are fully awake you may be able to sip water and progress gradually to fluids and, later, a light diet.

4 The following morning you will be able to have breakfast and get up to wash and prepare for discharge home. You may have abdominal pain / discomfort and may require pain relief to take home with you. You may experience some vaginal bleeding and discharge. If this continues for more than 2 weeks, becomes heavy or develops offensive odour please contact your GP. After surgery you may feel tired and lethargic for a few days (this is quite normal) so take short periods of rest during the day but also resume your normal life style as soon as possible. Leaving hospital: Key-hole surgery aims at empowering you to return to your routine soon after surgery. Please arrange for an adult to take you home the following day. You must also be cared for at home by an adult for the first 24 hours after discharge. Analgesia will be prescribed for you to take home on discharge. After going home you should feel better with time. Please contact Ward 3 (see contact numbers on back of leaflet) if you are not improving in any way. General advice:- Diet: Try to eat a healthy well balanced diet including plenty of fibre to avoid constipation. A low fat and low salt diet will help with your general health. Try to drink at least 2 litres of fluid per day (about 4 pints). Avoid alcohol for at least hours following your anaesthetic. Urine: If passing urine becomes painful (burning/stinging) or you experience any problems please consult your GP and take a sample for testing. If you are unable to pass urine please ring Ward 3 as you may need to have a catheter reinserted to empty your bladder.

5 Hygiene: You may shower, do not soak in a bath until your bleeding has completely stopped. Driving: You must not drive for at least 2 weeks after your operation. Please check with your insurance company as to how long would they like you to refrain from driving, this normally sooner following laparoscopic surgery than it is following open surgery. Sexual activity: Please refrain from penetrative sex for at least 6 weeks to allow the internal wounds to heal. Lifting and Exercise and work: Avoid heavy lifting for at least 12 weeks and aerobic workouts or strenuous exercises for 2-4 weeks. You may start gently when you feel comfortable. Generally we recommend that you take things gently for the first week, consider reasonable light duties in the second week, and try to gradually resume normal duties from the third week. This may vary between different individuals. You may find that you need to refrain from work for a few weeks. Any queries or concerns: If you have any concerns following your discharge, our trained Gynae staff on Ward 3 will be able to help. Contact telephone numbers are / They are available: 9am to 5pm Monday to Friday and 9am to 2pm over the weekend. For further information please visit: a-laparoscopic-hysterectomy

6 Useful contact details Gynae staff: / :00 am to 5:00 pm Monday to Friday and 9:00 am to 2:00 pm over the weekend Hospital Switchboard: Patient Relations Department The Patient Relations Department offer impartial advice and deal with any concerns or complaints the Trust receives. You can contact them via: Tel: You can also write to us at: Patient Relations Department, Blackpool Victoria Hospital, Whinney Heys Road, Blackpool FY3 8NR Further information is available on our website: References This leaflet is evidence based wherever the appropriate evidence is available, and represents an accumulation of expert opinion and professional interpretation. Details of the references used in writing this leaflet are available on request from: Policy Co-ordinator/Archivist Approved by: Clinical Improvement Committee Date of Publication: 10/06/2014 Reference No: lc PL858 (V1) Author: Adele Whitehead Review Date: 01/06/2017