Tuesday, May 3, 2011

Laparoscopy consent...


Possible complications of laparoscopy:

1. Failed entry to peritoneal cavity (eg: its a blind procedure, so you might consider converting to laparotomy if you have been unsuccessful in inserting the trocar? verres needle? for a few times: to avoid perforating bowels, or there might be adhesions etc2... not too sure exactly.. but failed entry is one of the possible complications)

2. Pre-peritoneal insufflation of gas : leading to SURGICAL EMPHYSEMA

3. Visceral injury:
- bowel, bladder, uterus, ureter, ovaries, tubes... (Bladder must be emptied before surgery!)
- high risk: obese, very thin and those with scarring/adhesions from previous surgery.

4. Risk of vascular injury

5. Risk of conversion to laparotomy



Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. 
- You're likely to feel some pain in your abdomen. You may also have pain in your shoulders. 
This is caused by the gas used to inflate your abdomen; it usually gets better within 48 hours.
If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. You may have some bruising on your abdomen around the areas where the laparoscope and any surgical instruments were put in. This usually gets better without treatment.

Complications

This is when problems occur during or after the procedure. Most women aren't affected. The possible complications of any operation include an 
1. unexpected reaction to the anaesthetic, 
2. excessive bleeding or 
3. developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).
The other main complications of having a gynaecological laparoscopy are listed below.
  • Your wounds may not heal properly or they may become infected.
  • You may develop a hernia.
  • Other organs in your abdomen, such as your bowel, bladder, womb or major blood vessels, may be damaged during the operation. However, this is uncommon.
  • During your laparoscopy, your surgeon may need to change to open surgery (Convert to LAPAROTOMY). This means making a bigger cut on your abdomen. This is done if it's impossible to complete the procedure safely using the laparoscope, or if there is a complication during laparoscopy that requires a larger cut to be made on your abdomen.
Most women experience no problems after having a gynaecological laparoscopy. However, if you develop any of the following symptoms, contact your doctor:
  • severe pain or pain that gets worse
  • a swollen abdomen
  • high temperature
  • wound redness or discharge
The exact risks are specific to you and will differ for every person, so we haven't included statistics here. Ask your surgeon to explain how these risks apply to you.

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