Total Laparoscopic Hysterectomy: About the surgery
You will be admitted to hospital on the day of your operation. Any pre-operative tests will be organised in the week before surgery. All patients are screened for MRSA, and antibiotics are given during the operation to minimise any chance of infection. You may be able to go home the following day, but some patients may be required, to stay for two nights.
You will have a general anaesthetic and three small incisions will be made in your abdomen. Each incision will be between 0.5 cm and 1 cm long – two low down and to the sides of your abdomen and one in your tummy button. Dissolving (absorbable) stitches are used. There is a further surgical cut internally at the top of the vagina but, again, dissolving stitches are used and so will not need to be removed or checked . Occasionally this internal stitch can come away after a few weeks but this would not cause concern.
You will have a catheter (tube) in your bladder to allow drainage of your urine. This will be inserted when you are asleep in theatre and is usually taken out after 24 hours.
The nursing staff will usually administer a tiny injection to the tummy wall to thin the blood and reduce the chance of a blood clot or deep venous thrombosis (DVT) developing. You will also be given special support stockings to wear on your lower legs to further reduce the risk of DVT.
Following your operation there will probably be a vaginal discharge (varying from a little fresh red, tailing off to a brown, then pink/clear, discharge). This is usually light and lasts for one to two weeks but you shouldn’t worry if it continues for up to four weeks after sugery. Very occasionally some patients experience a sudden gush of blood stained fluid which starts and stops suddenly. This is a discharge of trapped fluid from the upper vagina and usually is not a problem. If the discharge is smelly, you should contact the hospital to arrange a follow up appointment with Dr Martin.
You can expect pain and discomfort in your lower abdomen for at least the first few days after your operation. Some patients also have some pain over the shoulders. This is a common side-effect of laparoscopic surgery and is caused by the gas used during surgery. Some patients can feel bloated, and walking around and warm showers/baths may help. Some patients may require laxatives to help open the bowels and relieve the distended feeling.
When you go home, you will be given painkillers which you should take as directed for the first 48 hours and then as required, trying to reduce the dose when you feel more comfortable.
The day after surgery
Initially you will have a drip in your arm to provide you with fluid. We generally allow patients to eat and drink the day after surgery and if you feel well, the drip will be taken down. You will be encouraged to have a shower or bath and remove any dressings the day after your operation. A physiotherapist will provide you with advice on exercises to help you recover and move more easily. We encourage all patients to be as mobile as possible to help to further reduce the risk of DVT.