Name of the Procedure:

Excision or Destruction, Open, Intra-Abdominal Tumors, Cysts, or Endometriomas (5 cm or less)

Summary

This surgical procedure involves the removal or destruction of one or more tumors, cysts, or endometriomas within the abdominal cavity. This is done to manage growths located in the peritoneal, mesenteric, or retroperitoneal regions and the largest tumor must be 5 cm or less in diameter.

Purpose

The procedure addresses the presence of benign or malignant tumors, cysts, or endometriomas within the abdominal cavity. The primary goal is to remove these growths to prevent symptoms, complications, or further spread of the disease.

Indications

• Presence of intra-abdominal tumors, cysts, or endometriomas detected via imaging.
• Symptoms like abdominal pain, bloating, or discomfort.
• Evidence of tumor growth or potential malignancy.
• Failure of conservative treatments to manage the condition.

Preparation

• Patients are often required to fast for several hours before the procedure.
• Medication adjustments may be needed, particularly if the patient is on blood thinners.
• Pre-operative tests such as blood work, imaging studies (e.g., CT, MRI), and possibly a biopsy.
• A consent form will be signed after discussing the procedure and its risks with the surgical team.

Procedure Description

1. Anesthesia is administered, usually general, to ensure the patient is asleep and pain-free.
2. Surgeon makes an incision in the abdomen to access the affected area.
3. The tumor, cyst, or endometrioma is carefully excised or destroyed using surgical tools.
4. The area is checked for any remaining abnormal tissue.
5. The incision is closed with sutures or staples.
6. A specimen might be sent to pathology for further examination.

Duration

The procedure typically takes between 1 to 3 hours, depending on complexity and number of growths.

Setting

The procedure is performed in a hospital or surgical center equipped for major surgeries.

Personnel

• Surgeon specializing in abdominal or oncologic surgery.
• Anesthesiologist to manage anesthesia.
• Surgical nurse and operating room technicians to assist with the procedure.

Risks and Complications

• Infection at the incision site.
• Bleeding or hematoma formation.
• Injury to surrounding organs or structures.
• Blood clots or deep vein thrombosis.
• Adverse reactions to anesthesia.
• Possible need for further surgery if not all abnormal tissue is removed.

Benefits

• Removal of painful or symptomatic growths.
• Reduction in symptoms and risk of complications.
• In cases of malignancy, helps in controlling the spread of cancer.
• Outcomes typically realized within a few weeks post-surgery.

Recovery

• Hospital stay of 1-3 days is typical for monitoring and initial recovery.
• Instructions include wound care, activity restrictions, and medication management.
• Full recovery usually requires several weeks.
• Follow-up appointments to monitor healing and discuss pathology results.

Alternatives

• Minimally invasive procedures like laparoscopic surgery, if feasible.
• Non-surgical options such as watchful waiting, hormonal therapy, or chemotherapy/radiotherapy for malignant tumors.
• Pros and cons depend on the specific condition, location, and patient’s overall health.

Patient Experience

During the procedure, the patient is under general anesthesia and will not feel pain. Post-operatively, some discomfort and pain are expected, which can be managed with prescribed medications. Gradual return to normal activities as per doctor’s advice is typical, with attention to signs of complications and prompt reporting to healthcare providers.