Name of the Procedure:

Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)

• Common name: Laparoscopic oophorectomy or salpingectomy
• Medical term: Laparoscopic adnexal surgery

Summary

This procedure involves using minimally invasive laparoscopic techniques to remove one or both ovaries (oophorectomy) and/or fallopian tubes (salpingectomy). Small incisions are made in the abdomen, and specialized instruments are used to perform the surgery.

Purpose

The procedure addresses various medical conditions affecting the ovaries or fallopian tubes, such as ovarian cysts, endometriosis, ectopic pregnancy, or cancer. The goal is to relieve symptoms, prevent disease progression, or treat cancer, providing a chance for improved health and quality of life.

Indications

• Chronic pelvic pain due to ovarian cysts or endometriosis
• Ovarian or tubal ectopic pregnancy
• Benign or malignant ovarian tumors
• Genetic predisposition to ovarian cancer (e.g., BRCA mutations)
• Pelvic inflammatory disease not responding to other treatments

Preparation

• Fasting for at least 8 hours before the procedure
• Adjusting or stopping certain medications (as directed by the doctor)
• Preoperative blood tests, imaging studies (e.g., ultrasound, MRI), and possible EKG
• Signing a consent form after discussing the procedure with the surgeon

Procedure Description

1. Anesthesia is administered to put the patient to sleep.
2. A small incision is made near the navel, and a laparoscope (a thin tube with a camera) is inserted.
3. Additional small incisions are made to insert surgical instruments.
4. Carbon dioxide gas may be used to inflate the abdomen for better visibility.
5. The surgeon visualizes the adnexal structures and removes the necessary tissues.
6. The removed tissues are extracted through the small incisions.
7. The incisions are closed with sutures or surgical glue.
8. The patient is moved to the recovery area to wake up from anesthesia.

Duration

Typically, the procedure takes about 1 to 3 hours, depending on the complexity and extent of surgery.

Setting

The procedure is performed in a hospital or an outpatient surgical center equipped for laparoscopic surgery.

Personnel

• Surgeon specialized in laparoscopic procedures
• Anesthesiologist
• Scrub nurse or surgical technologist
• Operating room nurse

Risks and Complications

• Common risks: Infection, bleeding, and pain at the incision sites
• Less common risks: Injury to nearby organs (e.g., bladder, bowel), blood clots, anesthesia complications
• Rare complications: Adhesions, hernia at the incision site, persistent pelvic pain
• Postoperative care and close monitoring help manage complications

Benefits

• Minimally invasive with smaller incisions, leading to quicker recovery
• Reduced postoperative pain and shorter hospital stays
• Lower risk of complications compared to open surgery
• Potential relief from symptoms and prevention of serious health issues

Recovery

• Patients typically go home the same day or after an overnight stay
• Pain management with prescribed medications
• Avoid heavy lifting and strenuous activities for several weeks
• Follow-up appointments to monitor healing and discuss pathology results (if applicable)
• Gradual return to normal activities within 2 to 6 weeks

Alternatives

• Open (abdominal) surgery: More invasive, longer recovery
• Medical management (e.g., hormonal therapy) for conditions like endometriosis
• Conservative monitoring and follow-up for benign conditions
• Each alternative has its own risks and benefits; decisions should be made in consultation with a healthcare provider

Patient Experience

• During: The patient will be under general anesthesia and will not feel any pain.
• After: Some discomfort, bloating, and mild pain around incision sites are common. Pain management and comfort measures, such as rest and limited activity, will be provided. Most patients experience significant symptom relief and improvement in quality of life following recovery.