3rd laparoscopy tomorrow and first hysteroscopy... What happens when the op turns into a laparotomy?

Hi this is my first laparoscopy as a mum and I'm so worried how I'm going to look after my toddler. I'm scared they will remove my ovary which is stuck and damage my bowel..anyone had a bigger op than originally expected and how long is recovery. Though my 3rd lap in 5 years am still scared x

5 Replies

  • Oh and having hysteroscopy to remove a polyp

  • Hi, I had a 7 hour op to excise endo and a total hysterectomy for Adenomyosis all done laparoscopically. My ovary was stuck to my bowel also and had to be unstuck. A skilled endo surgeon is usually able to do this without resorting to laparotomy or to removing organs.

    Do you live in the UK and if so are you having surgery at a BSGE accredited endo centre where they have skilled endo surgeons plus the use of colorectal surgeons, urologists and pain management specialists if necessary? If you are in the UK and you are not under the care of an accredited centre it may be prudent to hold fire on yet another op and request a referral as is your right under NHS choices and NICE guidelines to such a centre. A list of accredited centres can be found at the following website: bsge.org.uk.

    Please be aware that even if your hospital is named as an accredited centre you need to check that you are seeing the named endo specialist on the list and not just the general gynaecologist at the hospital.

    Look for a centre that is skilled in excision surgery (ie cutting out the endo), not one that uses ablation to remove the endo as this proves less effective particularly in deeper infiltrating endo. Burning endo removes the top of endo rather than removing it from the root meaning much like a weed it's more likely to grow back resulting in the need for yet more surgery.

    With each surgery an endo sufferer runs the risk of further adhesions and scar tissue forming which can in itself cause pain and other issues so it's important to try to limit the number of surgeries required. Excision surgery offers the best chance of this with a skilled surgeon reducing the risk of reoccurrence in up to 50-60% of cases. This is why excision surgery is considered the gold standard in the treatment of endo.

    Sadly not even all BSGE accredited endo centres are equal, some are better than others so it pays to ask around and travel further afield if necessary to find the right surgeon for you. Don't be put off travelling distances - my surgery took almost 7 hours and my journey home was 2.5 hours. I was worried it would be awful but it really wasn't that bad.

    Whilst you cannot ask on this forum for specifics at to which centres are the better ones you can on EndoMetroplolis on Facebook so it may be worth going on this if you haven't already.

    I hope this helps and I wish you all the best, Jo x

  • I imagine you would need help the first week, but really depends if the op goes into anything else / what he finds can your partner / parents take time off to help xx

  • Hi - I realize that your lap is now very soon and you are getting concerned but you don't say what your endo situation is to be needing another lap. If you have any sort of complex/severe endo that involves your bowel area then this should only be dealt with by a specialist centre and in the right hands it would be very rare to need a laparotomy, even with the most severe cases. If you are being operated on in general gynaecology I would strongly suggest that you make it clear before your surgery that you don't want anything done for any rectovaginal endo or severe endo anywhere and you definitely don't give consent for a laparotomy. Make it clear that if they find a complex situation they must close you up and you would then need referral to a specialist centre. If you are being seen in a specialist centre then hopefully you should be in good hands. If the time comes that you want to seek referral to a centre please click on my name and look at my post on finding a specialist and feel free to pm me as to those that seem to be emerging as the best. x

  • I agree with Lindle and Jo. If you do go ahead make it clear that you do not want a laparotomy! I think it would be very unusual for them to switch to laparotomy. Has your surgeon warned you this might happen and if so what reasons were given?

    If this is your 3rd lap in 5 years then it tells me that it's time to change surgeons and make sure your next surgeon, should you need one, is an accredited endo specialist.

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