Laparoscopy - what actually happens? - Endometriosis UK

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Laparoscopy - what actually happens?

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I have taken the plunge and decided to have private treatment as I can't wait for the NHS any longer. I have a consultation Friday with my chosen consultant, who has come highly recommended so I am quite excited! I have also been given a potential provisional date of May 5th for surgery.

My question is, what actually happens? I have an endometrioma and disease has been felt on internal examinations, so I have been diagnosed with endo despite not having had a diagnostic lap, so I am hoping that during this lap I will have the blasted endometrioma removed, and any disease found excised? Is that typical? If it is a case of it being purely diagnostic, having a root around, sewing me up and then scheduling another surgery for treatment, then I would rethink going private. I understand that stuff like bowel and bladder problems can be complex and probably won't be done on the first one, but if anyone can inform me that would be great. My endometrioma causes me a huge amount of pain and discomfort so I just want it out, even if that means my ovary going with it - I am past caring!!

Thanks in advance

A xx

21 Replies
oldestnewest

I also went private and they removed the adhesions during my first lap. The only thing I would say is please please don’t assume that the lap is a silver bullet and everything will be great afterwards. I think I expected everything to be fixed and the problems to all be gone but unfortunately with this disease that doesn’t seem to be the case! Good luck with your op x

Hidden
Hidden in reply to Coops1109

Thank you, that is good to know, I am sure they will go over it on Friday but I like to hear peoples experiences! No I know, I am trying not to get my hopes up - I do think the cyst coming out will help, but I understand that I could end up with another and still have pain etc. Did you get any relief? thanks again x

Coops1109
Coops1109 in reply to Hidden

I’ve been really fortunate in that I haven’t suffered badly pain wise but I had really heavy and prolonged bleeding. I didn’t bleed for a month after the lap (they removed a chocolate cyst, adhesions and did a uterine scrape) but then my first period was back to going on for weeks. I’ve ended up going on the pill to try and regulate things.

Hidden
Hidden in reply to Coops1109

Pleased that other than the bleeding things have been looking brighter for you :)

Yay!

It would be good to check if you're having a diagnostic lap or diagnostic with removal of endo lap? I went for the latter as it mean one op rather than waiting for it so I knew I could look at starting to get better sooner - most private consultants look at the second option as their aim is to get you treated and on the mend. Ask how you're having your endo removed? lasered (removes just endo), ablation (removes top few layers of endo) or excision (removes endo and a bit of healthy tissue) options affect regrowth of endo, the latter being the best.

You'll be booked into a pre-op appointment a few weeks before where they take bloods, check any medication, what to expect, they'll run through anything you're worried about. You can also email your gynae or book an additional appointment directly if you want to know more.

The next part, depends on how much is done during surgery; day case or a few nights. Plan for an overnight; change of clothes (baggy), pjs, slippers, mini shower gel and shampoo, face wipes, baby wipes, pads (some women bleed after), peppermint tablets for the gas.

You'll be put under, and then they do the op; make 3 holes (usually or just one for diagnostic) in the belly button, on the bikini line and in-front of hip (about a cm length) - they may do up to 5 if needed. They put the instruments through these including a camera and lights). You're abdomen will be inflated a little so they can see better, at the end of the op they'll take the gas out and either stitch or glue the incisions, and the nurses will put plasters on them. As they can never remove all the gas that's what the peppermint is there for; it helps shift gas reducing pain. You'll come round but wont remember, that's when they take the tube out, quite often we wake up a little and hear people muttering, bleeping machines, then drift off again.

You'll wake up fully in recovery where they'll keep an eye on you before taking you back to your ward / room where you can rest. No one told me that your bladder is slow to respond due to the anaesthetic so it takes a while to wee!

Your surgeon should come round later or the next day to explain what they've done. The nurses will let you know what you can / cannot do and give you a leaving pack (mine did). Then it's up to you.

Recovery wise, a lot has been done even though it doesn't look it, so expect to be in pain the first few days directly around the op sites and inside. You should try to move around as much as you can bear, moving helps flush out the antibiotics (can take up to 48 hours to get out of the system) it speeds recovery too; so even if its from the bed to the sofa and then potter around the house, doing some moving helps. But take it easy, stock up on painkillers, you can take ibuprofen and paracetamol at the same time if you're okay with them. Hot water bottles help but use it after 2 days; the drowsiness from the antibiotics can cause you to fall asleep with it and possibly burn yourself.

Have a shower on the second day after the op; you can get extra plasters; I got hypoallergenic non woven ones from amazon (I just looked up the brand I was given in my post op pack) Change your plasters once a day for about 4 days. If they're healing fine then take them off and let them air dry - I have colloidal silver spray (amazon) that I use for all wounds as an antimicrobial as I find the creams like savlon make the scab soften and so it opens, this stuff doesn't do that. If any cuts look like they're red / weeping white / yellow then see your doc. Any dissolvable stitches can take a few weeks to go. Keep plasters on any cuts you think will catch on your clothes.

On the note of clothes, wear baggy ones, I wore leggings, and nighties, or size up jogging bottoms and pjs. Expect bloating as your insides are healing, this can take up to a week to go. You should be able to move around normally after about a week, but take it easy as some stuff may still hurt. In the second week start doing more exercise, yoga I found helped with stretches and breathing. The second week you'll feel more drained and annoyed with yourself; if you have removal of endo the pain may feel like it's back, it isn't, the body can't tell the difference between removal of endo pain and endo pain. Two weeks is the usual for time off work, but you may still feel tired.

It may take up to four months to be back to 100%. You should have a check up apt 2 weeks after op and another 4 months after (not all places do these)

I had a diagnostic and removal (excision) of endo lap, was back at work on the third week after op, I went back to full exercise and sports clubs 5 weeks after, and three months later I'd say I'm almost back at 100%.

My pain from endo has almost gone, the lap allowed me to work out my cycles, when the pain and other symptoms were happening so I could better plan around it.

My specialist said he expects to see most women that are seen by him (and whom he operated on) to present with recurrent endo symptoms bad enough to mention two years after their lap, and most needing a second lap three to 5 years later. He didn't pressure for hormones as he understood the idea of seeing and dealing directly with what's wrong then looking at how to deal with the remaining symptoms: I'm not having any additional treatment, I'll just see how things go.

I didn't know what endo was until my appointment with my specialist! We talked about it all and he suggested a lap and excision of endo (plus biopsies of anything else) almost immediately, no other treatment was suggested.

I had my lap pretty soon after, and he reported severe endo around my bladder, uterus and bowel, also with all stuck to each other. He's removed all endo and unstuck everything in the one lap, but I'll need another to remove endo on bowel (needs a bowel surgeon), which I'm okay with.

Wow that's a long post, sorry!

Hidden
Hidden in reply to farahziya

Hello! Wow, brilliant post! I am going to ask for anything to be treated during the op, I would rather get as much done in one swoop. The consultant is an excision specialist, it was one of the reasons I chose him :) this advice is so so helpful, I have saved it! Where abouts was your specialist based?

Interested around your experience with exercise, I absolutely love the gym and do a mix of running, HIIT (mainly burpees!) and weight lifting. The thought of not going is making me anxiousa but I know I need to heal, and I am struggling to do it at the moment as I swell when I do anything high impact or 'jiggly' so ive been doing weights only. Did you find that you were in pain doing sports prior to the op? It is really important to me.

Really pleased you had such a positive experience with it, you seem very upbeat even though you have another op ahead, I am a big fan of positive mental attitude I think it helps a lot :D thanks again xx

farahziya
farahziya in reply to Hidden

Yeah, sorry it was a bit long, glad it's useful!! I wish someone had told me what would happen before I went in; I found this site after my op.

I found my specialist through our work insurance; private have a "freedom to choose"; so I looked up ones in my area (Gloucestershire) and found my specialist, he's part of The Gynaecology Group, specialises in heavy periods, fertility, endometriosis, surgery, laparoscopy, and post menopause.

The op won't sort everything, some pain may still remain, some symptoms may still remain, but you'll know whatever was causing those particular problems has been removed and you can get your life back while seeing what else there is you could do. I still have symptoms, but after the lap they're manageable as I can now track my cycle, and see when my bad days are so I can plan around that.

Exercise; I usually swim, HIIT, self defense, kickboxing and polefitness. All of these have aspects of yoga for warming up and cooling down so I incorporated that into my lap recovery. Yeah I had a bit of pain, but not bloating / swelling. It was mainly during stretches or say HIIT when using my core lots. It's definitely improved now, but you'll need to go easy; you may need to wait 3 to 4 weeks before going back to the gym. I was okay enough on the 4th week but had to miss some stuff out of my classes; I was just honest and explained what went on, everyone was really supportive in my classes. Over time I became more confident with my recovery and trusted my body more. It's taken me 4 months to say I'm back to 100%.

I try to stay positive :) A lot of coping with endo is mental; how you are, how you think, how your partner is. Also positivity actually helps recovery. I don't believe in feeling sorry for yourself; things happen for a reason, whatever that reason, we get through it and when you're feeling good, make the most of it. I have my hubby to thank too as he comes to my appointments, was there after my op and has helped me emotionally; just having someone to talk to that's close to you everyday. I go with the philosophy; if I'm happy people will want to be around me, I can share my life and the good times with them, so when I don't feel I can cope I know they'll be there :) And the opposite if you're always down, you'll pull people with you, people don't like that so they gradually keep their distance; they have their own life.

Stay positive, happy vibes work wonders for coping xx

I hope you're op goes well :)

Hidden
Hidden in reply to farahziya

You sound like a truly fabulous person, I am sure those in your life are so grateful! Thank you so much for sharing your experience, I have felt nervous but you've set my mind at ease a little. Good to know your exercise experience too as I know to some people it's trivial but it is my little outlet and my time to focus on myself so I want to rest as required but make sure I do get back to it.

I like to try and be upbeat too, I sometimes get a bit down but it doesn't get you anywhere, totally agree with you. Thanks again x x

farahziya
farahziya in reply to Hidden

Aww thanks :)

I've been hurt and trampled on by sooo many people during my life that I've thought I must be horrible; I've learned actually it's because I'm so nice some people take advantage of that and make friendships all about them. I never saw that before until I took a step back especially with my endo and lap; I've changed and I now realise I let people do that to me. Not anymore, I am me, my own person, if you like me that's good, but I won't stand for any rubbish! It's made me more grateful for friends I do have, and happier as a person

We all need "me" time and we need to make time, value and appreciate it. Focus on you, if you're okay and positive then that helps your health too :)

Yes, I was the same as you, I went private as I was sick of waiting! I had my lap one week ago today. It was meant to be diagnostic as whilst I was myself 100% certain I was endo, the medical professionals said my ultrasound and physical were both 'normal'. HOWEVER, during the lap, they found what they described as 'extensive' endo lesions everywhere, and apparently spent a good 1-2 hours just removing them all. So whilst I was meant to be a day case, it turned into an overnight stay due to the severity of the op and my pain on waking. But it is fantastic that a) I now have a diagnosis and b) it has been thoroughly treated. Going private, they also did a nice job of sealing the wounds with surgical glue, so all nice and straight forward from the incisions side of things at least.

Like the others have said, do expect a significant recovery time... It is definitely a process and not a silver bullet. I'm signed off for two weeks, but as things currently stand, I can't quite imagine being back to normal by next week!

Best of luck to you.

farahziya
farahziya in reply to Sfarre

that glue is weird, mine fell off like a scab after a week and a bit, and the underneath looked like what you'd find under a scab! But it's nicer and smoother than stitches.

Sfarre
Sfarre in reply to farahziya

Haha yes. I must admit to be rather unclear on the concept, it's a bit strange! Do you know at what stage post op I can soak in the bath, by any chance?

farahziya
farahziya in reply to Sfarre

I left it until about 7 to 8 days after before I had a bath (just a quick 10 min one), it hadn't come off after. I then had a longer soak about 10 days after and the glue came off when drying - much like a scab does, it looked fine underneath.

Hidden
Hidden in reply to Sfarre

Are you pleased you went private? We know our own bodies so well, I bet you were relieved to hear it's been removed and hopefully you'll have some normality once recovery is over. It's not the answer to our prayers but it is something hey :) I am actually weirdly nervous they'll find nothing and I'll have wasted time and money, even though I have an endometrioma, lots of fluid in my pelvis, scarring present on internal exams etc and every symptom in the book I've just been waiting so long that I've sort of convinced myself otherwise which sounds really stupid. I obviously don't want endometriosis but I would be scared if nothing was found then why am I always in pain. But it does sound like I have it, it's on my medical records and my GP has absolutely no doubts. Just my overactive mind! Thank you for sharing your experience it is invaluable to me to hear all these stories xx

farahziya
farahziya in reply to Hidden

Yes definitely, so much quicker, careing, thorough,and spend the time to explain stuff but then it is what you're paying for!

I know how you feel; I was worried they wouldn't find anything. Don't worry too much, just get through it and wait to see what the results are then look at next steps - one thing at a time :)

Hidden
Hidden in reply to farahziya

My NHS appointment came through today for the end of June! now I am torn about what to do - it is a BSGE centre on the NHS too, so from that I am assuming they are the best at what they do?

farahziya
farahziya in reply to Hidden

I didn't go to a BSGE center I went private as I have medical insurance through work. I guess they would be equal to each other. There are some good specialists on the NHS too, it's all down to experience and their speciality; if a doctor specialises they can focus on that and experience to have treated lots and to know the problems. They will be better than a general doctor or a general consultant if that's what you mean!

Hi i had mine on Friday. Things i had forgotten since my last lap...who ever picks you up, get them to bring pillows/ cushions to sit on as that would have helped and made journey home more comfortable. Also i just had Ibroprofen and paracetamols stocked piled, but get something stronger especially for the first 48 hours. Once i did it managed the pain well! Hope all goes well and just look after yourself x

Hidden
Hidden in reply to Chidders

Oh good tip thank you I have over two hours travel home so I will be very glad of that!! Hopefully you're recovering well xx

farahziya
farahziya in reply to Hidden

oh and make sure you can go for a wee during your journey home - the anaesthetic affects your bladder so when it feels full it hurts and can sometimes take a while to tinkle so plan that in on the way home. I was picked up and home was only 30 mins but I was dying for a wee 20 mins in!

As well as all the brilliant recommendations from others, I would add, be prepared to feel nauseous and maybe even be sick after the procedure due to the anaesthetic. Have stronger pain killers than just paracetamol and a heat pack handy just in case. Some good advice I got was to drink lots of green tea while recovering as it helps to detox your body from the gas they use to expand your abdomen. Constipation could also be a problem for a few days after the procedure - eat lots of fibre! Give yourself plenty of time to feel normal again, bloating and cramps and dizziness and bruising will stick around for a couple of weeks but the internal healing also takes awhile and you may still be getting cramps for a number of weeks afterward.

I felt the same frustrations as you waiting for the public health system (in Australia) to help me, and went private fro my first lap. Despite the expense, I don't regret it. I also had a mirena inserted to help prevent the endo from coming back too soon - it's only been a cpl of months and I'm not sure this has helped yet as I still experience quite intense pain from time to time!

- Also, after the procedure I ate a lot of anti inflammatory foods like pineapple, blueberries walnuts, salmon, spinach etc - I think it helped :)

Good luck with it all! x

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