Too slim for lap??

[becausemanson]

The hospital have finally agreed to do an investigative lap to look for Endo. But the doctor went on for ages talking about the risks because I'm slimmer. I'm around 9 stone, slim flame, never gain weight on my stomach, so I was worried when he was saying that there is a higher risk of puncturing organs and leaving me in more pain. I signed it anyway and am going ahead with it. I just wanted to get your opinions? Are there any women the same build that have been told the same things?

[Hidden]

No, I've not heard that before (though they always go on about the risks during any surgery). I would ask for a second opinion or see whether there's anything about it online. Possible puncturing is a natural concern but I don't see why if you're slim or big it makes a difference - the organs generally are the same size?!

[KML22]

I'm very small as well (less than 9st - I'm mostly recovered from anorexia, but it's still a bit of a struggle sometimes) and my lap went without a hitch. My surgeon didn't even mention that as a risk, and it wasn't part of the consent form. Is the lap being done by a specialist endo centre? It seems from reading posts on here that the biggest risk factor is if the surgeons aren't really specialist at endo-related operations! I really hope you can get care from people who are confident about their skills <3

[becausemanson in reply to KML22]

Not at a specialist centre unfortunately. I hope it will go well, thank you xx

[LauraKl08]

I'm only 8 stone small frame very flat belly iv had 5 laps and never been told this risk and no problems with my 5 so i wouldn't worry good luck xx

[becausemanson in reply to LauraKl08]

Thank you, hopefully it will be fine xx

[miss_doll]

They did not mention that to me and I'm 9 stone too. I thought they blow you up with the gas so that there is more room to rummage around anyway! Take care x

[becausemanson in reply to miss_doll]

That's what I thought, I had watched the surgery being done on the internet and saw they use gas and a camera before inserting other instruments, so I would have thought they could have more room. Thanks xx

[Juls1971]

I'm 9 stone and had my lap 4 weeks ago and no problems. Good luck, you will be fine xx

[becausemanson in reply to Juls1971]

Thank you xx

[Brownlow]

Personally, if a surgeon said that to me it would set off alarm bells. I was just under 8 stone when I had my lap for extensive, complicated stage 4 endo and fibroids with a very good endo specialist. I switched to her because a previous endo specialist wanted to do the whole thing by open surgery and do a hysterectomy too. He said he was "concerned about the risks". The translation for that is "I am not confident in my own skills". He was worried he might puncture a major artery near some fibroids and a laparotomy afforded better access in an emergency. I ran a mile...no, about a hundred miles to another surgeon who was baffled by the original surgeon's assertion and found the fibroids very easy to access and remove by keyhole.

If it was just presented to you as a general risk then that's different. All operations carry some degree of risk and rarely, organs may be punctured. However, he has already tried to put this risk onto you by saying your slim frame is a risk. Ask him how many incidents of punctured organs he has had and how many were in slim framed people. Ask him for scientific studies, reports and data that clearly conclude that having a slim frame increases the risk of organ puncture. You will most likely find that organ puncture scenarios will be due to other reasons one of which is surgical skill. A skilled surgeon using gas to inflate the abdomen should have no trouble.

Ask more questions or better still, change surgeon.

Is this guy an accredited endo specialist?

[becausemanson in reply to Brownlow]

No he's not an endo specialist as far as I know. I pushed and pushed for a referral to a specialist centre, but doctors refused. A lap done at a bog standard hospital was all they could offer. It was a very rushed consultation I thought, in and out of the room within under 5 minutes.

[RedMae84 in reply to becausemanson]

Don't feel rushed into surgery if you're not feeling 100% happy with your consultant and everything else. Why did they refuse you to see a specialist? that sounds really off to me, its like their just trying to get it 'over and done' with! I was lucky to find my specialist, who also gave me her email address and would reply to any of my questions before and after surgery. It definitely made me feel like I was in good hands.

It is vital with things like this that you see a specialist who is experienced in the field, your GP has no right to refuse you that, there are plenty of good NHS specialists around the UK .

[Brownlow]

Being underweight is a risk factor for complications but at 9 stone I shouldn't think you are in the underweight category. The complications are general and are not specifically about organ puncture. I can't find any reports on slim build or underweight and the increased risk of organ puncture. Do you know your BMI?

I was definitely underweight for my surgery but the reason I was underweight was because I was so ill with endo. Following surgery I am now a healthy weight.

Did you discuss whether or not he would remove any endo if he found any?

[becausemanson in reply to Brownlow]

I don't know my bmi lately. Being on the pill recently has helped bulk me out a little everywhere except my stomach. I used to be underweight because of periods making me ill so much and nausea killing any appetite.

He said if there were small spots he would burn them off, but anything more he wouldn't be able to touch because it might make the pain worse.

[Brownlow in reply to becausemanson]

BMI is a bit too general anyway but it is the measurement used in studies. Your situation sounds similar to mine in that your illness is causing you to lose weight.

I do feel that some doctors could be better at informing patients of risks. They need to do this in a balanced manner that does not cause the patient fear and anxiety that is out of proportion to the actual risk. He seems unduly concerned about this aspect.

Unfortunately I have come to learn on this forum that removing endo by laser, diathermy, burning, whatever, is inferior to surgical cutting which requires significantly more skill. If not surgically cut out there is a higher risk of it returning. What you could do is opt for diagnostic lap only and tell him if he finds any endo to leave it and refer you on to an endo specialist. At least he has said he will not tackle anything more than 'small spots'. Did he say he'd refer you on to an endo centre if he found advanced endo?

[RedMae84]

I've never heard of that, in fact I was worried that my weight (I was at the time just under 8 stone) would be a problem before my cyst removal and lap but nothing like that mentioned. As a matter of fact the whole team of nurses and my specialist were very supportive. To me that doesn't make sense, because then every girl who is skinny would be warned about those risks.