Gynecological Surgery Types


Exploratory Laparotomy:    Open exploration of the abdomen.


Total Abdominal Hysterectomy:  Removal of uterus, cervix, ovaries and tubes.


Bilateral Salpingo-oopherectomy:  Removal of both ovaries and fallopian tubes. 


Laparoscopic 2nd Look:  This is sometimes recommended after chemotherapy has been completed and there is no evidence of disease by physical exam, CT scan, or tumor marker.  This allows the doctor to examine the abdomen directly and take fluid and tissue samples to see whether the treatment has been successful.  Most often this can be accomplished laparoscopically or with the use of small scopes, instead of a full incision.  If cancer is found on 2nd Look, additional treatment is needed. 

Incisions

Vertical/Midline:  Up and down incision usually extending from just above the pubic hair to the umbilicus.  At times, it is necessary to extend the incision just above the umbilicus.


Pfannensteil:  This incision stretches across the lower abdomen just above the pubic hair, similar to a cesarean section scar.


Laparoscopic:  This is accomplised using small incisions usually three to five.  Cameras and instruments are inserted into ports to view the abdomen, take biopsies or take down adhesions as needed.

Bowel Prep

     If you are having surgery for a pelvic mass, ovarian carcinoma, or a laparoscopic procedure, we may ask you to begin a bowel prep the day before surgery.  If asked, you may be given or mailed a prescription along with directions for the bowel prep prior to surgery. These preps are extremely important to create a clean environment throughout your bowel.  If for some reason, surgery is performed on your bowel during your scheduled procedure, this will allow for reattachment or closure without the need to create a colostomy.

On the day before your surgery, you are instructed to have a light breakfast and lunch, then a clear liquid diet for the remainder of this day. 


Clear liquid diet includes:

Water Tea Coffee (without milk products)
Juices Broth Strained soups (without meat or vegetables)
Soda  Jell-O  Toast (no butter)
Sherbet Soda crackers    

*Do not eat or drink anything (including water) after midnight.


Possible Complications from Surgery:

*infection
*bleeding and injury to the bladder, rectum or ureter causing a leak
*blood clots in the legs, which can occasionally dislodge and travel to the lungs (pulmonary embolism)


Additional Information: 
In younger women whose ovaries are removed during surgery, the body’s natural source of estrogen is lost and menopause will begin.  Symptoms of menopause are likely to appear soon after the surgery and hormone replacement therapy is sometimes used to ease symptoms such as hot flashes, vaginal dryness and mood swings.  Ovarian and uterine cancer patients should discuss the risks and benefits of using hormone replacement therapy as estrogen in certain individuals can be an increased risk of recurrent disease.