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Ovarian and tubal surgery

The fallopian tube and ovary are very well situated in the pelvis and almost all operations for nonmalignant problems of these organs can be most effectively achieved while using laparoscopic approach. The operations are called adnexal surgery and include:

1. Ovarian cystectomy - Removal of cysts on the ovaries with preservation of the ovary
2. Oophorectomy - Removal of the ovary
3. Salpingectomy - Elimination of the Fallopian tube
4. Salpingotomy - Opening the tube to remove an abnormality e.g. ectopic pregnancy
5. Adhesolysis - Freeing the tube or ovary from adhesions to lessen pain or improve fertility

Several operations can be performed as day surgery. It is advisable to discuss your recovery needs with your doctor to ensure the best planning for you.

ADVANTAGES OF LAPAROSCOPIC ADNEXAL SURGERY

1. Small incisions and fewer scarring
2. Better views of the tubes and ovaries
3. Gentler handling from the body tissues and organs throughout the operation
4. Less blood loss during the operation
5. Less postoperative pain
6. Less postoperative narcotic use to decrease your pain
7. Shorter hospitalisation
8. Faster overall recovery with an earlier go back to normal activity

TECHNIQUES OF LAPAROSCOPIC ADNEXAL SURGERY

1. Preoperative preparation may involve a shave and a small enema. Fasting for 6 hours preop is required.
2. An over-all anaesthetic is administered.
3. The laparoscope and other instruments are introduced as described.
4. The blood supply to the tube or ovary is secured if removal would be to occur and so the tube or ovary is free of its supports.
5. When the tube or ovary is to be saved the cyst or abnormality is removed and the tube or ovary repaired.
6. The specimen is taken away and the wounds repaired.

Immediate postoperative recovery involves either discharge from the day surgery centre or a night in hospital. Patients are welcome to rest in hospital provided they need to. Patients will be given as much pain alleviation because they request to make sure they're comfortable either as tablets or injections.

The initial few days in your own home should be taken effortlessly. The patient must have anyone to help. Plenty of rest and fluids are advisable. Exercise your calf muscles to prevent clots. Oral pain relief e.g. Panadeine/Panadol may be required, especially at night. Generally recovery will be complete within a week or so.

All patients should individually assess their recovery rate. Some may require additional time off work than others and certificates will always be provided.