Laparoscopy Surgery

October 18, 2008 8:12 PM

What to expect from a laparoscopy?

I have been diagnosed with endometriosis and on Tuesday I have my first and hopefully last laparoscopy. My doctor is sort of erratic lately, though an expert in the field. He believes he can cure stage 1 and 2. In his patients there is only a 3% chance of it coming back in these stages. He does not believe in hormone therapy, but in extracting the disease.

They pushed my appointment to this Tuesday and my mom can't come up, so my can't-see-blood-or-i-puke dad is. I think she's trying t make it on Wednesday.

OK, here's my question. What should I expect? Should I have someone stay over the first night (i live by myself)? I am in my early 20's.

Can you notice I'm a bit nervous! And did I tell you I have a severe belly button phobia....

posted by octomato to health & fitness (17 answers total)

I had laparoscopic surgery for both an appendectomy and a gall bladder removal, not endometriosis. I can tell you that having someone in the house with me those first few nights was very helpful for 3 reasons: 1) the combo of pain meds, anesthesia effects, and a very sore abdomen made me want/need to stay in bed and have things brought to me as needed, 2) the anesthesia caused me to have problems peeing afterward, and I needed to be driven to the urologist the next day, 3) it was nice to have someone else checking on me and taking stock of how I was doing, since I was not myself and was in no shape to judge what was normal and what wasn't.

If you have the choice, I say have someone stay with you for a couple of nights. Good luck!
posted by ImproviseOrDie at 8:36 PM on October 18, 2008

Just had this exact procedure two weeks ago. Your doctor shouldn't even let you have this surgery unless you have someone to drive you home so make sure you have transportation back to your house.

The first night you can expect to have a very hard time sleeping, getting up from a lying position and urinating. You may also experience nausea from the anesthesia. The next morning you will begin to possibly experience tremendous pain from the C02 they use to inflate your stomach during the procedure. The doctor will try to eliminate most of the gas but the rest will dissipate through your body causing acute pain in your shoulders and chest. The best remedy is to walk around to help the gases move around.

You really need to have a person around for a few days to take care of you. You will not be able to walk easily or drive yourself anywhere should you need too.

This is NOT minor surgery despite the size of the small incisions and the fact that you can leave the hospital the same day. You must get a ton of rest for a few days in order for your body to recover.

Treat yourself gently and please have someone stay with you!
posted by yfatah at 8:56 PM on October 18, 2008

I lived with gall bladder difficulties for years due to my fears - surgery, anesthesia, etc. Once I had no choice (pain didn't resolve), they performed lap surgery. You will be able to handle most things by yourself. I am very out of shape and the only thing nobody prepared me for was the abdomen inflation. Due to the inflation, as I was told, my shoulders and arms were so sore that I couldn't sit up in bed. I had to roll out of bed awkwardly and roll quickly into bed. I'm a single mom with no family, but I do have a helpful teenage son.

Aside from bringing me stuff (water, snacks, meds), he didn't need to do much. There was no blood or icky involved. The bandages stayed on through quick showers and I was told to not remove bandages until after my follow-up visit. He kept track of my med schedule and I slept most of the time. Since you know ahead of time, make sure you get all pain meds and snacks before your surgery. You'll want easy to eat, no prepare, quick snacks and drinks. I lived on ice cream, jello, pudding, a little mashed potatoes, smoothies, popsicles and such for a few days. I was concerned about nausea and had no real appetite.

If I did it over again, I'd make sure there was someone with me the first 48 hours home. After that, I could manage. The bandaged lap holes never actually hurt, just a little twinge every now and then. My shoulder and back actually hurt. I thought I was getting worse, because the shoulder pain didn't start until around 36 to 48 hours. There were times I simply couldn't move top half of my back.

If you decide to go it alone, make sure you have some friends/family on-call.
posted by ick at 9:06 PM on October 18, 2008

Oh yeah, the CO2 effect! When it first kicked in, I thought something was really wrong and it was helpful to have my husband there to find the surgeon's number and do the "is this normal?" phone call. Man, that was pretty painful, and like yfatah and ick said, it made it very difficult to get out of bed without assistance until I learned how to roll out and into a standing position.
posted by ImproviseOrDie at 9:15 PM on October 18, 2008

I had a laparoscopy to remove my ovaries, and apparently I had an easier time of it than other posters here. The surgeon went straight for the ovaries and didn't try to remove endometriosis tissue, so it's possible my surgery was less invasive than yours might be. I had two small incisions, one for each ovary.

It was done on an outpatient basis. A friend drove me home and basically tucked me in. A nurse had told me firmly I *must* have someone stay with me the first night because the effects of the anesthesia might make me do dumb things like leave a burner on. I didn't have someone stay with me but did promise my friends that I wouldn't even attempt to go down stairs or do anything remotely risky. Which I didn't--I just slept very nicely. I didn't have any trouble getting up, peeing, etc.

I had stocked up on frozen meals and puttered about the house for a couple of days eating out of the microwave. I had also stocked up on ginger in anticipation of nausea but didn't feel queasy. I was happily eating my regular food the day after the surgery.

I had some pain for a few days after the surgery, but it was less pain than I would have felt from a typical period (my periods were cursing, pillow-gnawing affairs with bursts of sobbing). I took one dose of pain meds about two days after the surgery, to deal with the gas pain rather than the incisions. The gas pain gets better if you walk around.

Thanks to the gas pain and some minor stiffness in my abdomen, I walked hunched over for a few days. For about a week, I got in and out of the car slowly and was careful not to step heavily or jar myself.

The after-effect that surprised me most was the brain fog that was apparently induced by the anesthesia. I was slightly stupid for about a week--forgetting things, making typos, getting easily confused. So you might make sure your workload is mentally light for a week or two, and you might avoid driving until you're sure you're alert enough.

I hope your surgery gives you relief. Endometriosis was only one reason for my surgery, but I was ecstatic to end my painful periods. I hadn't realized how much they had limited my life until they were gone. My immune system is also hugely improved--I almost never get sick now.
posted by PatoPata at 9:25 PM on October 18, 2008

Oh yea, bring baggy waisted pants for the trip back home. I couldn't wear my pre-surgery jeans until about 7 days after surgery.

You might want to pickup some of those extra big, waterproof bandages, too. I think I had 3"x3" to cover my entire belly button area and 2"x2" to cover the smaller holes. There was absolutely zero ick in dealing with the bandages. The stitches didn't need removing either. I too was freaked about the belly button bit, which is why I just covered the whole area.
posted by ick at 9:34 PM on October 18, 2008

I had a lap for my early stage but terrifically painful endo a couple of years ago (just before I turned 21). I was led to believe it would be a no big deal sort of thing, but was floored for a week. I had major abdominal pain, bloating, constipation, and an utter inability to care for myself for at least 48 hours. The incisions were no big deal, but the peripheral pain from inflation and having my muscles lifted off my abdomen where a lot worse than I expected. Truly, it was much harder than I thought it would be, but I don't know if my experience was normal or worse than normal.

As for the treatment of my my endo, I was incredibly disappointed. In retrospect, my doc wasn't experienced enough with the disease. As I understand now, she couldn't deal with the endo on the back side of my uterus. I was young and scared, so I wasn't a good enough advocate for myself; if/when I do it again, I'll go with a specialist with much more expertise. My research has led me to believe that excisions cut deeper and works better than the laser burning I did originally. I did a course of Lupron shortly thereafter and loathed it (miserable symptoms and it didn't help the endo at all). Cycling my birth control pills so I only have four (miserable, hideous) periods a year is my current imperfect solution.

In general, I've met many more women who have had to treat their endo over and over again than ones who managed to deal with it in one treatment. I hope you get lucky and that isn't the case, but if that isn't how it works out, try not to be to disappointed. For many women, endometriosis is a chronic disease. Realizing there was something wrong with me that I couldn't easily fix or cure, that I'd have to deal with for a long time, was very hard and emotionally difficult. Please mefi mail me if there's any questions I can answer or help I can provide.
posted by mostlymartha at 9:38 PM on October 18, 2008

I had a laproscopic appendectomy a few years ago.

I don't know how common this is, but the post-surgery medication fucked me up. You know how they list a bunch of things after "Side effects may include"? For me, side effects included those things. When I got up to use the bathroom, I walked into the walls because of the dizziness.

So: yes, I recommend having someone look after you for a couple of days. I was more or less good to go by the end of the week -- I would have been able to survive on my own, at least -- but it's possible (if not likely) that you'll need the help right when you get back.
posted by danb at 10:06 PM on October 18, 2008

I had a laparoscopy for endometriosis and to remove a cyst on my ovary just this March. Everything went as it had been explained to me by my doctor, except I had very bad nausea after the surgery. As a result, I got a lot of extra fluids that made me have to pee, which caused me extra bad times once I got home (for whatever reason -- the catheter they used? -- peeing was both excruciating and slow/difficult for the first 24 hours or so). But I had no gas pains at all. I was very bloated and sore around my belly -- picture a very pregnant person trying to get out of a chair; that's how you'll be moving around for a while. I hate narcotic painkillers, so after the first night I was on just a mega-dose of ibuprofen and it was tolerable. I was able to go back to work 5 (maybe 6, can't remember) days after surgery, though I wore super-soft pants for a while after that.

The bandages weren't very gross, I had no weeping or anything like that. There were three incisions, one teeny one, one medium one, and the biggest one was below my belly button. That one was only like an inch across, no big deal.

My boyfriend took care of me and he saw no blood at any time, so your dad should be fine. I needed someone with me for a couple of days, so I hope your dad can stay and help you walk around or just serve you snacks in bed. Even just the first overnight would be helpful.

I was also a bit disappointed with the surgery, because my gyno only got the cyst and whatever endo she could see. (To be fair, we weren't sure if I had endo at all before she got in there -- I've been lucky to not really have any typical endo symptoms.) I have some attached to my bowel, but since she didn't have me do a bowel prep, she couldn't remove it. So if I ever want all of it gone I have to do this all again (and have to do a bowel prep first, ugh).

Anyway, it's real surgery, but the part that sucks is really only about a day. You slowly feel better and you get to do a lot of TV-watching and sleeping in the meantime while your body does its thing. And now I have no cyst, which is very nice. Please memail me if you want to know any other details.
posted by chowflap at 10:12 PM on October 18, 2008

Wait - I lied. The one near my belly button was tiny, the inch-long main incision is like four inches below that. So there was minimal action happening near my belly button. (I had to look to make sure! I have some faint scars, still.)
posted by chowflap at 10:31 PM on October 18, 2008

I had an exploratory laparoscopy after a miscarriage. The after-effects of the anesthesia and the pain meds made me a zombie for a couple of days, so definitely ask someone to stay with you, at least overnight. Also watch out for nausea and dizziness for the first 48 hours. Best wishes.
posted by amyms at 11:05 PM on October 18, 2008

I had an emergency laparoscopy for a twisted fallopian tube (from a gigantic cyst) and while I didn't have much pain in my abdomen afterward, my shoulders were killing me for about 48 hours because of the gas trying to dissipate.

The other thing you might want to be aware of is that sometimes--not often--the doc will forget to take the catheter out while you're still anesthetized (that's what my very kind nurse told me--that it was accidentally left in) and it'll have to be removed while you're awake. Had I known this at the time, I might have made some kind of friendly, joking reminder to the doc as I was wheeled in to not forget the catheter. It's really, really not fun to have a catheter pulled out.

But on the bright side, this procedure will probably be over before you know it. When I woke up, I asked the recovery nurse when we were going to start, and she told me that it was all over. Time can go very wonky when you're under general anesthesia. Also, when you wake up from the anesthetic, you might experience a bit of thrashing around, which is 'just your muscles waking up' according to my friend the recovery nurse.

Definitely have someone come and help you out for a few days, even if it's just to have someone around. For me, all the stress of having emergency surgery (and though yours is scheduled, it's still really stressful) sort of came crashing down a couple of days later. YMMV.

Best of luck to you. I know it seems really scary, but I was pleasantly surprised that it was over in what literally seemed a blink of an eye. Also, know that the OR staff sees scared, stressed out people in pain every day and they will in all likelihood be super, super nice to you. And no one will roll their eyes if you, say, cry. ;-)
posted by corey flood at 11:06 PM on October 18, 2008

my shoulders were killing me for about 48 hours because of the gas trying to dissipate

Oh gawd, yes, I forgot about that. Have a good friend come around and give you a shoulder rub.
posted by amyms at 11:15 PM on October 18, 2008

I had an appendectomy this way, and I had a very positive experience. There were three small scars that have completely disappeared now. The CO2 effects afterwards were pretty weird, because your diaphragm and shoulders will be sore, and it's kind of confusing. But honestly, it wasn't that bad for me at all -- I was just very confused until the nurse explained the effect to me. Other than that, it was smooth sailing and relatively quick recovery (since there's no huge incisions).

Since you're in your early 20's, you're definitely going to have some trouble peeing, but again it's not that big of a deal. You'll be uncomfortable for maybe a day or two, then your body will most likely adjust.
posted by spiderskull at 1:15 AM on October 19, 2008

...that is to say, a positive attitude will go a long way. I know this is easier said than done, but just try your best to be comfortable with your surgeons and nurses -- they're experienced people who know what they're doing. I didn't feel terribly uncomfortable past the first night (in my case, the anti-inflammatories kept me from getting deep sleep).

And make sure you have people you like visit and take care of you, if at all possible. An mp3 or CD player and a Sudoku book will be crucial during recovery, because TV gets old quickly when you're stuck in a bed.
posted by spiderskull at 1:19 AM on October 19, 2008

I had a lap appendectomy a few years ago. I was in the hospital overnight. I remember waking up thinking, that's it? It seemed pretty easy for surgery.
I passed a lot of gas (getting rid of the CO2). I don't remember much pain at all, either right after the procedure or recovering at home.
Give yourself plenty of time to recover. You are still having surgery and they are still moving your innards around. Take your pain meds, even if you don't think you need them, because proactive pain management is a better way to do it than waiting until you are in so much pain you can't sleep. BTW, it is OK to ask for a sleeping pill prescription, too, because sometimes when you are recovering from surgery and not doing much during the day, you won't get tired enough to sleep at night, but you need the rest.
I would recommend having someone around to help you, but more in the realm of make some sandwiches and soup for you, bring you juice and water, etc. Not to help bathe you.
posted by FergieBelle at 8:08 AM on October 19, 2008

I just had one this summer, and I developed a minor infection in the navel incision, so be sure to follow aftercare instructions to the letter! (I tried, but I think I have a hard time healing anyway.)

I had difficulty for about 2 weeks afterward. Abdominal incisions are trickier than my surgeon led me to believe. But it wasn't too bad and I was largely functional after the first 2 days. Do have someone with you for at least the first evening/day after. The CO2 dissipates easier if you can move around some -- if not, then lie flat. Peppermint tea helped me, too, as did backrubs.

I underestimated my surgery, and was surprised that the healing process took a while. My friend who had this done in the UK said she was not allowed to drive for 2 weeks after! They definitely downplay it as "minor surgery" here in the US. That said, minor surgery is still surgery -- don't be afraid to take it slow & easy, and give yourself time to heal.
posted by dryad at 12:38 PM on October 25, 2008