Open Salpingo-oophorectomy

WHAT YOU SHOULD KNOW:

• Open salpingo-oophorectomy (sal-ping-go-of-o-REK-tah-me) is surgery to remove one or both fallopian tubes together with the ovaries. The fallopian tubes are attached on one end to your uterus (womb) and to the ovaries on the other. The ovaries are a pair of organs in the lower abdomen (stomach) that make eggs and female hormones. When one of your ovaries releases an egg, the egg passes through the tube to your uterus. The female hormones, such as estrogen and progesterone, are special chemicals which help the body work correctly. A salpingo-oophorectomy is done to remove cysts, tumors, adhesions, or blockages, and treat infections in the tubes and ovaries. It is also done to treat pregnancies where the fertilized egg grows outside the womb. It may be needed to stop the ovaries from making hormones that increase your risk for having breast and ovarian cancer.
  
  
• With an open salpingo-oophorectomy, your caregiver will do the surgery by making an incision (cut) in your abdomen. Your caregiver may take out one or both sets of your tubes and ovaries. Your caregiver may only remove a tube and an ovary on one side. You may still be able to get pregnant after this surgery. In some cases, both sets of tubes and ovaries are removed. This will make you infertile and unable to become pregnant. With an open salpingo-oophorectomy, problems in your reproductive system may be treated and the symptoms they cause relieved

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Problems, such as bleeding that cannot be controlled, may happen during your surgery. Your stomach, intestines, blood vessels, or nerves may also get injured. You may feel pain and weakness in your abdominal muscles after the surgery. You could also have trouble breathing or get an infection. There is also a chance that your problems may return or you may still have cancer.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.
  
  
• Without treatment, your health condition may worsen and cause further damage to your reproductive system. Your risk of having cancer may also increase. Once you have cancer, it may spread and other serious problems may develop. You may need more treatment, such as medicines and surgeries. Ask your caregiver if you are worried or have questions about your surgery, condition, medicine, or care.

WHILE YOU ARE HERE:

Before your surgery:

• Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• Enema: You may need to have an enema before your surgery. This is liquid put into your rectum to help empty its contents.
  
  
• An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.
  
  
• Anesthesia: This medicine is given to make you comfortable. You may not feel discomfort, pressure, or pain. An adult will need to drive you home and should stay with you for 24 hours. Ask your caregiver if you can drive or use machinery within 24 hours. Also ask if and when you can drink alcohol or use over-the-counter medicine. You may not want to make important decisions until 24 hours have passed.
  
  
• Foley catheter: This is a tube caregivers put into your bladder to drain your urine into a bag. Keep the bag below your waist. This will help prevent infection and other problems caused by urine flowing back into your bladder. Do not pull on the catheter, because this may cause pain and bleeding, and the catheter could come out. Keep the catheter tubing free of kinks so your urine will flow into the bag. Caregivers will remove the catheter as soon as possible, to help prevent infection.
  
  
• Monitoring:
  
  
  • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
    
    
  • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
    
    
  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

During your surgery:

• Your abdomen and genital area are cleaned and covered with clean sheets.
  
  
• Your caregiver makes an incision on your lower abdomen. He uses special tools to pull the layers of the skin and muscles to have a better view. He cuts the part near the uterus where your tubes and ovaries are attached. These ends are stitched (tied) and closed. If ovarian cysts have burst, the abdomen is thoroughly washed and cleaned. Thin rubber tubes may be placed to drain blood from your incision. Your incision is closed with stitches (threads) or surgical tape and covered with bandages. A vaginal pack or sanitary pad may be placed for the bleeding.

After your surgery:

• You are taken to a recovery room until you are fully awake. The endotracheal tube (the tube to help you breathe during your surgery) may be removed after you are awake and can breathe well on your own. The catheter that drains your urine may need to remain for a while. Your caregiver watches you closely for any problems.
  
  
• Do not get out of bed until your caregiver says it is OK. When your caregiver sees that you are OK, you will be taken back to your hospital room. The bandages used to cover your stitches keep the area clean and dry to prevent infection. A caregiver may remove the bandages soon after your surgery to check your wound or drains. Ask your caregiver for more information about ways to prevent bleeding and take care of your incision.
  
  
• Activity: You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.
  
  
• Deep breathing and coughing: This will help decrease your risk for a lung infection after surgery.
  
  
  • Hold a pillow tightly against your incision when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breaths help open your airways. Let the air out and follow with a strong cough. Spit out any mucus you cough up. Repeat the steps 10 times every hour.
    
    
  • You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece into your mouth and take a slow, deep breath. Let out your breath and cough. Repeat the steps 10 times every hour.
  
  
• Food and drink after surgery: You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.
  
  
• Medicines: You may be given the following medicines:
  
  
  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    
    
  • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
    
    
  • Hormone medicines: After the ovaries are removed, you will not be able to make female hormones. Your caregiver may give you hormone medicines to replace one or more female hormones in your body. These are used to help decrease symptoms of early menopause (change of life). Hormone medicines also have some health benefits, such as decreasing your risk of having bone fractures and certain cancers. Ask your caregiver for more information about hormone medicines.
    
    
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
    
    
    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
      
      
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
    
    
  • Others: If you have other conditions or diseases, you may also need medicines to treat them. These may include blood pressure or heart medicines, insulin, or diabetic pills. You may also continue being treated with chemotherapy or radiation therapy if you have cancer. Your caregiver may suggest other medicines to help control other signs and symptoms that may be present.
  
  
• Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.
  
  
• Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.
  
  
• Tests and monitoring: Caregivers will take your vital signs frequently for several hours. The pulses on your legs and feet will also be checked often. This may help the caregiver know if you have any problems with blood flow after your surgery. Samples of your blood and urine may be taken and sent to a lab for tests.