Your Guide to Laparotomy

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Your Guide to Laparotomy
Women’s Health Unit
Your Guide to a Laparotomy
(Major Abdominal Surgery)
Leighton Hospital
Middlewich Road
Crewe
Cheshire CW1 4QJ
www.mcht.nhs.uk
November 2005
Impressions 01270 767661
Direct Line: 01270 612051
This leaflet has been written and produced to inform you, your partner
and family in order to assist and support you if you are considering or
have been recommended this surgery. It is not intended to replace
verbal information with your surgeon and specialist nurse. You can
access other information via websites available – see end of leaflet.
Questions you may want to ask
Benefits and reasons for having a laparotomy
The aim of this surgery is to give the best possible outcome of your
treatment.
Your partner and carer may also have concerns and questions about
how they can help you, and how your condition and treatment will
affect them.
Try to find out as much as you can about your treatment options and
make a list of questions you may want to ask the doctor.
What is a Laparotomy ?
A laparotomy means an operation to look inside the abdomen.
Samples from other tissues such as the lymph glands and a fatty
layer, called the omentum, may also be taken. It may sometimes be
necessary to remove a small piece of bowel and rejoin the ends.
The procedure can involve the removal of organs :
•
For an ectopic pregnancy (a pregnancy outside the womb, in the
tubes) this may involve the removal of the tube affected.
•
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Ovarian cysts – removal of cavity or sac containing liquid or semi
solid matter.
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Useful addresses
Women’s Health Concern Ltd
10 Storey’s Gate
Westminster
London
SW1P 3AY
Tel: 020 7799 9897
www.womens-health-concern.org
Provides information and advice on gynaecological problems.
Publishes a wide range of leaflets
Wellbeing
27 Sussex Place
Regents Park
London
NW1 4SP
Tel: 020 7772 6400
Fax: 020 7724 7725
email: [email protected]
www.wellbeingofwomen.org.uk
Reassure women and provide information. The only national charity
fund raising for research into women’s health at every stage.
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•
Myomectomy – the removal of fibroids (balls of muscle) which
form in the wall of the womb.
•
Adhesions – scar tissue which can form between internal organs
causing them to ‘stick’ together, often as a result of infection or
previous surgery, but may also be caused by endometriosis.
•
Finding and stopping bleeding.
The incision (cut) in your abdomen (tummy) will be vertical (up and
down) or a bikini line. This allows the consultant to thoroughly assess
your condition. A sample of fluid may also be taken from the area in
the operation.
Alternatives
By the time you have reached this stage, the alternatives will have
been explained e.g. laparoscopic procedures. If you have any
concerns please ask the nurse at the assessment clinic.
Consent to treatment
Consent – We must by law obtain your written or verbal consent to
any operation and procedure. Staff will explain the risks, benefits and
alternatives. You may then be asked to sign a consent form, if you
have not already done so. If you are unsure about any aspect of the
treatment proposed, please do not hesitate to speak to a member of
staff.
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Risks and complications of surgery
Going home what can I do?
Possible complications at the time of the operation. Although we try to
make sure that any problems are reduced to a minimum, no surgical
operation can be guaranteed free of complications and the operation
itself.
Once home remember that you are still recovering. Take the
opportunity to pamper yourself and let others look after you for a
change. It is important to rest, but equally important to have some
daily exercise.
These may appear unpleasant, but please remember that they occur
very rarely. Some can occur during the operation but others may not
happen until after you have gone home :-
For the first week or two you should really do as you have been doing
in hospital. After that increase your activities as you feel able. Please
remember it could take up to 3 months before you are doing as you
did prior to surgery. Please contact Ward 18 if you have any worries
or concerns during the first week after leaving hospital.
•
•
The general anaesthetic may occasionally give rise to difficulties
which will may make your stay in hospital longer or your recovery
slower.
Reaction to general anaesthetic – there is always a small risk of a
serious reaction of complication associated with having a general
anaesthetic whatever the procedure. (If you smoke you have an
increased risk of chest infection).
•
Bleeding - As with all operations there is a risk of bleeding
(haemorrhage) which may require you to have a blood
transfusion.
•
Organ damage – there is occasionally damage to other
structures (the bowel or bladder or ureter). If this does happen
we will repair it immediately while you are still anaesthetised.
•
Return to theatre for additional stitches - these will be checked by
staff in the recovery area before you return to the ward.
•
Pelvic abscess or infection.
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Driving can be resumed 4-6 weeks after surgery, however it is
advisable to check with your insurance company.
The doctor will provide you with up to 28 days supply of medication.
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After your operation
When you return from theatre you will normally have an intravenous
infusion (drip) into your arm, which provides your body with the
necessary fluids until the nursing staff will advise you on when you
can start to eat and drink again.
•
Venous thrombosis/pulmonary embolism.
•
Wind pain - the operation does result in wind floating about in
the abdomen, which can cause pain in the shoulder, back and
abdomen. A few days after the operation eating small quantities
of fruit and vegetables, and drinking plenty of fluid will help to re
establish your normal bowel movements. Painkillers and moving
about will also ease the discomfort.
Pain Relief – You will have some pain and discomfort for a few days.
Pain relief will be offered in the form of PCA (Patient Controlled
Analgesia), injection or tablet. An information leaflet is available to
explain methods of pain relief but nursing staff will help you and this
will be discussed at the pre operative assessment clinic.
You may have a catheter into the bladder which drains urine into a
bag. This is normally removed after 24-48 hours.
In order to prevent blood clot formation (thrombosis) a Flowtrons
(cuff) or injections of calciparine will be used, and discussed at the pre
operative assessment clinic.
You will be encouraged to start moving about as soon as possible
after the operation which is essential for your recovery. Leg exercises
and deep breathing are important while you are in bed. The
physiotherapist will help with these.
Risks following surgery
Frequent risks may include:
•
Wound infection and bruising
•
Frequency of passing urine
•
Delayed wound healing
•
Scar formation (keyloid)
The risks will be discussed with you at the pre operative assessment
clinic.
Your clips/sutures (stitches) are normally removed 5-7 days after
surgery. Some stitches are put underneath the skin and will dissolve
naturally.
Providing you recovered well, you should feel able to go home 5-7
days after your operation.
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What happens before the operation?
Pre Operative Assessment – 1-2 weeks before your operation you
will be asked to attend the pre operative assessment clinic (POAC).
This will give you the opportunity to meet with nursing staff, they will
discuss the type of operation you will be having and what you can
expect before and after treatment. You will also have the opportunity
to ask any questions you may have.
At the POAC please bring a list of all your medication with you.
You will receive a leaflet about the assessment along with your
appointment date for admission.
Pubic hair will need to be removed prior to surgery, no sooner than
the night before operation.
You can remove it by shaving or by the use of depilatory creams,
please check for sensitivity if you do not use them as routine.
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In Hospital - before the operation
You will be shown to your bed by a nurse in your team. The nurse
will introduce herself and show you the ward layout. (For further
information about services and facilities available on the ward please
see the information booklet sent with your admission letter).
You will normally be admitted on the morning of your operation.
You will not be able to eat or drink anything for 6 hours before your
operation. If your operation is in the morning you must starve from
12 midnight the night before your operation or if your operation is
planned for the afternoon you may eat a light breakfast before 7am.
Please will you contact the ward on 01270 612051 on the day of
surgery to confirm a bed is available for you.
We will do our utmost to ensure we do not cancel planned operations,
but emergencies will take priority.
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