Home About John Fairbank NHS Practice Private PracticeColposcopy ClinicsFAQ's Clinical Info Useful Links

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Operations: Laparoscopy & therapeutic procedures including laser, diathermy & destruction e.g. endometriosis, adhesiolysis, tubal surgery

Insurance code: Q3800

Introduction: This information is written by John Fairbank and is provided for the benefit of his patients. Additional information will be given during consultation in the clinic and during the pre-operative discussion. It is not appropriate for all surgeons’ individual practice or for all patients.

Purpose of operation: Laparoscopy allows access to the pelvis through conveniently small holes. Operations can then be carried out through a series of small incisions for a variety of reasons including the treatment of endometriosis and the removal of small ovarian cysts. Laparoscopic techniques allow for quicker recovery times and shorter hospital stays. Not all operations can be done laparoscopically however and some procedures carry additional risks.

Description of procedure: A series of small incisions are made on the anterior abdominal wall. One incision is just below the umbilicus and a further one or two incisions are made above the bikini line for other instruments to pass through. The pelvis is assessed. Any necessary surgery can then be carried out. For example deposits of endometriosis can be removed surgically, or treated with bi-polar or monopolar diathermy or with application of Helica energy. The exact procedure depends on the condition being treated and the operative findings. The small incisions are closed with dissolving sutures that usually do not require removal. A D and C (scrape) of the uterine cavity is often carried out to remove the thickened lining of the uterus to prevent a heavy and tedious post-operative discharge.

Anaesthetic: These operations are usually carried out under general anaesthetic.

Length of stay: A single night stay is typical although patients may occasionally require an extra night.

Post-operative management: If a catheter has been inserted it is normally removed the following day. The IV fluid line is left in place until oral fluids are tolerated. The painkilling pump is kept in place until it is no longer required. Stitches or skin staples are normally removed the day of discharge from hospital.

Potential complications
Complications at the time of surgery include peri-operative bleeding, and damage to structures such as bladder and bowel. These complications are rare but require corrective surgery immediately or as soon as a problem is recognised. Venous thrombosis (DVT) can follow any pelvic surgery. Stockings are therefore worn and heparin injections given each day to reduce the risk. Early mobilisation and early discharge from hospital reduce the risk of thrombosis.

Post-operative consultation
A post-operative consultation is usually made for one week for discussion of findings and wound inspection with either Mr Fairbank, Mr Fairbank’s staff or the General practitioner depending on the complexity of the case. Laparoscopic sterilisation cases do not usually require a hospital follow up appointment. Most patients will require seven to ten days recovery before returning to work.

Other considerations
Sex and exercise are best avoided until the skin has healed and sutures have dissolved. This may take up to four weeks. Heavy lifting is best avoided but light lifting is not a problem. Driving short distances is practical once comfortable and strong sedative pain killers are no longer being taken.

Other web sites

Information on laparoscopy

More Information on laparoscopy

Information on endometriosis