LAPAROSCOPIC OVARIAN CYST...........

What Is an Ovarian Cyst?

Ovarian cyst  are common, especially with woman who still get their period. They’re solid or fluid-filled pockets in or on your ovary. Most of the time they’re painless and harmless. You might get one every month as part of your cycle and never know it. They usually go away on their own without treatment. Cysts are also common when you’re pregnant 

A cyst becomes a problem when it doesn’t go away or gets bigger. It can become painful. There’s also the possibility of cancer, but it’s rare. The chances go up as you get older.

What Are the Symptoms?

Most ovarian cysts are small and don’t cause any problems. When there are symptoms, you might have pressure, bloating, swelling, or pain in the lower abdomen on the side of the cyst. This pain may be sharp or dull, and it can come and go.Sometimes a cyst may need emergency attention. See your doctor right away if you have these symptoms:

• Sudden, severe belly pain
• Pain with fever and throwing up
• Dizziness weakness , feeling faint
• Fast breathing

These signs could mean your cyst has caused the ovary to twist.

Is My Pain Caused By An Ovarian Cyst?

Sometimes your doctor finds cysts during a pelvic (female) exam. Your doctor will ask questions about your pain and other symptoms.

She might give you an ultrasound . This is a device that uses sound waves to take pictures inside your body. It can show the details of a cyst

WHEN SURGERY IS REQUIRED 

When surgery is required even for very large ovarian cysts, laparoscopic surgery should be the modality of choice, and most surgery for ovarian cysts are performed as day cases.

The advantage of laparoscopic surgery for ovarian cysts are the fact that

1.     It is less pain full, and less pain killers are required

2.     Hospital stay is less

3.     Recovery and resumption of normal activity is quicker

4.     Blood loss during the procedure is less

5.     Better cosmetic appearance of the scars

The procedure is carried out through an incision in the “belly button” and 2 or 3 small 5mm incisions are often used to insert the fine instruments used for the procedure

Most often women only need to take a few days to a week off work.

It is very rare particularly if the cysts are benign for traditional open surgery to be necessary. I would always advise women to seek a second opinion if they encounter surgeons whose primary method of treatment of ovarian cysts is Laparotomy.

Recovery after laparoscopic ovarian cystectomy

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Most cases of removal of ovarian cysts are performed as day cases. However on depending on how long the operation takes an overnight stay may be necessary.

How you recover after a laparoscopy in general, will depend on how fit you are and how long the operation takes. 

                                   Ovarian cyst

After Surgery 

You will be monitored closely for a few hours until after the anaesthetic wears off. Once you are able to walk and get out of bed without help and have emptied your bladder you will be allowed to go home. If you are unable to empty the bladder of have lot of pain or sickness be prepared to stay. 

What to Expect? 

Going Home 

Even though you may feel awake the effects of anaesthetic may take some time to wear 

• It can make you drowsy slow clumsy, unsteady on your feet and forgetful so:
• Plan to have a friend or relative to take you home and stay overnight.
• Avoid driving, alcohol, using power tools, or even boiling a kettle of water till 24 hours after.
• Wear low-heeled shoes.

For the drive home recline your seat halfway. Hug a pillow gently against your tummy to soften any road bumps. Have a paper bag and tissues nearby in case you vomit. 

Pain 

You may have a period like crampy pain for a day or two. The amount you have depends on how much surgery you have had. 

Sneezing, laughing, crying and coughing may be uncomfortable. The pain should improve by the next day and can be eased by taking the usual painkillers and wearing loose fitting clothes to prevent any pressure on your tummy especially the belly button. Lie in whichever position is most comfortable. 

If it helps, keep your legs bent upwards, propping your legs up with pillows. Hugging a pillow can also help protect your cuts especially if you are lying on your side or with your partner. The gas used to swell up your tummy can cause rib, neck or shoulder pain and tummy bloating. It may also make you burp or break wind a lot. It will take a few days for the symptoms to ease. Try moving around and lying flat to help the gas disappear. Heat (e.g. hot water bottle, warm shower) massage and drinking water either hot or cold /tea with fresh lemon can also help as can peppermints. your partner. The gas used to swell up your tummy can cause rib, next or shoulder pain and tummy bloating. It may also make you burp or fart a lot. It will take a few days for the symptoms to ease. Try moving around and lying flat to help the gas disappear. Heat (e.g. hot water bottle, warm shower) massage and drinking water either hot or cold /tea with fresh lemon can also help as can peppermints. 

Activity 

Expect to feel sore and “washed out for the first few days .Most women need at least 2 days to recover from the anaesthetic alone. In this time spend as much time as possible lying down or sleeping. After this if you feel up to it, walk around the house a little bit but don’t overdo it or you may end up feeling light headed and exhausted. It is usually safe to resume your normal activities but avoid strenuous exercises /activity until you are feeling fit, usually after your first post operative visit. Arrange to take a week off work but ask your doctor as it largely depends on your condition and the type of surgery performed. 

Sore Throat 

You may experience sore throat caused by the irritation of the tube passed down your throat during anaesthesia. Throat lozenges may help. 

Eating 

Nausea as a result of anaesthetic may be made worse by greasy or oily food. Try eating light easily digestible food for a few days such as a cup of tea, soup, dry toast, jelly or crackers. Start with liquids and slowly work up to a normal diet as your stomach will accept it. Room temperature foods are better than hot or cold foods at first. Chewing gums or sucking on hard sweets can help control nausea as can waving an alcohol wipe under your nose (ask nurses for a few).To prevent dehydration and constipation (side effects of both general anaesthesia and pain killers )be sure to drink lots of fluids and include high fibre fruits and vegetables like prunes and spinach. 

Cuts

Keep your cuts clean by bathing and showering as normal and dry your skin thoroughly. Avoid possible irritants like talc or bubble bath. If you have stitches they usually dissolve over a few weeks or can be removed by your GP, You may also have a watery pink tinged discharge from your cuts for a day or two. Steri strips which look like tape may be used to cover your cuts and prevent your clothing from rubbing on them. They can be removed 2 to 3 days following surgery or if they become too wet. The cuts tend to heal quickly and tech to itch more than they hurt. The area around your belly button will be tender and swollen for a week so avoid clothing that may rub. 

Bleeding 

You may have light vaginal discharge or bleeding like at the end of the period. It will last for up to 2 weeks. If your laparoscopy was to investigate infertility, there may also be some bluish discharge (from a blue dye used during surgery). 

To reduce the risk of infection whilst bleeding: 

• Use sanitary towels instead of tampons.
• Avoid sexual intercourse until the bleeding has stopped
• Avoid swimming
• Shower rather than bathe

Dr. Neeti Gupta
(Gynecologist, Laparoscopic surgeon & infertility specialist)
Renowned Obstetrician In Indore.
Call For Appointment: 7692976910