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What you need to know about a laparoscopic hysterectomy:
A laparoscopic hysterectomy is surgery to remove your uterus. Your ovaries, fallopian tubes, cervix, or part of your vagina may also need to be removed. The organs and tissue that will be removed depends on your medical condition.
How to prepare for a laparoscopic hysterectomy:
Your healthcare provider will talk to you about how to prepare for surgery. He may tell you not to eat or drink anything after midnight on the day of your surgery. You will need to stop taking aspirin 7 to 10 days before your procedure. You will need to stop taking NSAIDs 3 days before you procedure. You will also need to stop taking certain herbal supplements 7 days before your procedure. These include garlic, gingko biloba, and ginseng. Your provider will tell you what medicines to take or not take on the day of your surgery. You will be given an antibiotic through your IV to help prevent a bacterial infection. Arrange for someone to drive you home and stay with you after surgery.
What will happen during a laparoscopic hysterectomy:
- You may be given general anesthesia to keep you asleep and free from pain during surgery. You may instead be given regional anesthesia to numb the lower part of your body. Your surgeon will make several small incisions in your abdomen. He will place a laparoscope and other tools into your abdomen through these incisions. A laparoscope is a long metal tube with a light and camera on the end. Your abdomen will be filled with a gas to allow your surgeon to see inside your abdomen more clearly. For a robot-assisted hysterectomy, your surgeon will use a robotic machine to help him do the surgery.
- Your surgeon will remove your uterus. He may also remove other organs or tissue such as your ovaries, fallopian tubes, cervix, lymph nodes, or part of your vagina. Your incisions will be closed with stitches, staples, surgical glue, or surgical tape. The incisions may be covered with a bandage. A vaginal pack or sanitary pad may be used to absorb the bleeding. A vaginal pack is a special gauze that is inserted into the vagina. It is removed before you go home or to a hospital room.
What will happen after a laparoscopic hysterectomy:
You may have a catheter to help drain your bladder for up to 24 hours. You may also have pain in your shoulders or near your ribs if gas was put in your abdomen. You will have pain for the first few days after surgery. You will need to wear sanitary pads for vaginal bleeding that occurs after surgery. You will be asked to walk as soon as possible after surgery. This will help to prevent blood clots in your legs. You may be able to go home on the day of surgery.
Risks of a laparoscopic hysterectomy:
- The surgeon may need to change from a laparoscopic surgery to an open abdominal surgery. You will not be able to become pregnant after you have a hysterectomy. If your ovaries are removed during surgery, you will go through menopause. You may bleed more than expected or get an infection. Your bladder, ureters, or bowels may be damaged during surgery. If your ureters were injured, you may need a catheter to drain your bladder for several days to weeks.
- You may get scar tissue in your abdomen that blocks your intestine or causes pelvic pain. If you have a hysterectomy to treat cancer, this surgery may not remove all of the cancer. You may get a blood clot in your leg, arm, or lungs. This may become life-threatening.
Call 911 for any of the following:
- You feel lightheaded, short of breath, and have chest pain.
- You cough up blood.
Seek care immediately:
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
- You have increasing abdominal or pelvic pain.
- You have heavy vaginal bleeding that fills 1 or more sanitary pads in 1 hour.
Contact your healthcare provider or gynecologist if:
- You have a fever.
- You have nausea or are vomiting.
- You feel pain or burning when you urinate, or you have trouble urinating.
- You have pus or a foul-smelling odor coming from your vagina.
- Your wound is red, swollen, or draining pus.
- You feel pressure in your rectum.
- You have questions or concerns about your condition or care.
You may need any of the following:
- Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely.
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
- Stool softeners help treat or prevent constipation.
- Take your medicine as directed. Call your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
- Wear an abdominal binder as directed. An abdominal binder will decrease pain when you move or cough.
- Rest as needed. Get up and move around as directed to help prevent blood clots. Start with short walks and slowly increase the distance every day. Limit the number of times you climb stairs to 2 times each day. Plan most of your daily activities on one level of your home.
- Do not lift objects heavier than 10 pounds for 6 weeks. Avoid strenuous activity for 2 weeks.
- Do not strain during bowel movements. High-fiber foods and extra liquids can help you prevent constipation. Examples of high-fiber foods are fruit and bran. Prune juice and water are good liquids to drink.
- Do not have sex, use tampons, or douche for up to 8 weeks. Ask your healthcare provider if it is okay to take a tub bath.
- Do not go into pools or hot tubs for 6 weeks or as directed.
- Ask when it is safe for you to drive, return to work, and return to other regular activities.
Care for your abdominal incisions as directed. Carefully wash around the wound with soap and water. It is okay to let the soap and water run over your incision. Do not scrub your incision. Dry the area and put on new, clean bandages as directed. Change your bandages when they get wet or dirty. If you have strips of medical tape, let them fall off on their own. It may take 7 to 14 days for them to fall off. Check your incision every day for redness, swelling, or pus.
Take deep breaths and cough 10 times each hour. This will decrease your risk for a lung infection. Take a deep breath and hold it for as long as you can. Let the air out and then cough strongly. Deep breaths help open your airway. You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece in your mouth and take a slow, deep breath, then let the air out and cough. Repeat these steps 10 times every hour.
This surgery may be life-changing for you and your family. You will no longer be able to get pregnant. Sudden changes in the levels of your hormones may occur and cause mood swings and depression. You may feel angry, sad, or frightened, or cry frequently and unexpectedly. These feelings are normal. Talk to your healthcare provider about where you can get support. You can also ask if hormone replacement medicine is right for you.
Follow up with your healthcare provider or gynecologist as directed:
You may need to return to have stitches removed, and for other tests. Write down your questions so you remember to ask them during your visits.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.