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.

Getting Ready

The week before your surgery:

• Ask a family member or friend to drive you home after your surgery. Do not drive yourself home.
  
  
• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• Tell your caregiver about all the other diseases you may have. These may include diabetes (high blood sugar level), cancer, bleeding disorders, or heart problems. Your caregiver may need to treat you before your surgery to prevent possible problems.
  
  
• Tell your caregiver if you know or think you are pregnant.
  
  
• Tell your caregiver if you already had this kind of surgery or other surgeries before, and when they were done.
  
  
• You may need to have different blood and urine tests or an electrocardiogram (ECG). Imaging tests, such as x-rays, computerized tomography (CT) scan, magnetic resonance imaging (MRI), or an ultrasound may also be done. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.
  
  
• Your caregiver may suggest that you have counseling about your surgery and condition. He may talk to you or your family about your expectations, benefits, and possible outcomes of the surgery.
  
  
• You may need a blood transfusion if you lose a large amount of blood during surgery. Some people are worried about getting AIDS, hepatitis, or the West Nile virus from a blood transfusion. The risk of this happening is very low. Blood banks test all donated blood for AIDS, hepatitis, and the West Nile virus. You may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than three days before surgery. You may also ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your surgery. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before surgery. You may need to check your blood sugar more often before and after having surgery.

The night before your surgery:

• Ask caregivers about directions for eating and drinking.
  
  
• Bowel preparation: You will need to clean out your bowel to get ready for this surgery. Your caregiver may ask you to do one or more of the following:
  
  
  • You may need medicine called an enema. An enema uses warm water that is put into your rectum to help empty your rectum. Ask your caregiver how to do this, and follow the directions on the package.
    
    
  • You may be given 8 to 12 (eight-ounce) cups of special bowel prep medicine to drink. Drink one eight-ounce cup of bowel prep medicine every 10 minutes until you are passing clear fluids. Ask your caregiver for more information about this medicine.
  
  
• You may be given medicine to help you sleep.

The day of your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• What to bring: You may want to bring items such as a toothbrush and bathrobe.
  
  
• Ask your caregiver before taking any medicine on the day of your surgery. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
  
  
• Bowel preparation:
  
  
  • Do not eat or drink anything on the morning of your surgery. Your bowel needs to be totally empty during your surgery. If you need to take medicines, you may have them the morning of your surgery with few small sips of water.
    
    
  • You may need an additional enema, using warm water, the morning of your surgery.
    
    
  • You may also be asked to drink 4 to 8 (eight-ounce) cups of special bowel prep medicine. This may need to be done if you drank the bowel prep medicine the night before.
  
  
• If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses may be worn.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

Treatment

What will happen:

• You may be given medicine to help you relax or make you drowsy. You will be taken on a stretcher to the operating room and then moved onto a special bed. Your abdomen and genital area will be cleaned with soap and water. Sheets will be put over you to keep the surgery area clean. Caregivers may give a regional or general anesthesia to keep you asleep during surgery. If a general anesthesia will be given, an endotracheal (ET) tube connected to a breathing machine may be put into your mouth. This goes down the windpipe to keep your airways open and help you breathe during your surgery. A catheter may be inserted to drain your urine.
  
  
• Your caregiver will make an incision on your lower abdomen. He will use special tools to pull the abdominal muscles to each side. He will cut the part near the womb where your tubes and ovaries are attached. These ends will be stitched (tied) and closed. If ovarian cysts have burst, the abdomen will be thoroughly washed and cleaned. Thin rubber tubes may be placed to drain blood from your incision. Your incision will be closed with stitches (threads) or surgical tape and covered with bandages. A vaginal pack or sanitary pad may be used for the bleeding.

After your surgery:

• You will be taken to a recovery room until you are fully awake. The ET tube 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. Caregivers will watch you closely for any problems.
  
  
• Do not get out of bed until your caregiver says it is OK. When caregivers see 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.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your appointment on time.
  
  
• You have a fever.
  
  
• You have questions or concerns about your surgery.

Seek Care Immediately if

• You have blood, pus, or foul-smelling odor coming out from your vagina.
  
  
• You have sudden severe abdominal (stomach) or vaginal pain.
  
  
• Your signs and symptoms are getting worse.