Laparoscopic Hysterectomy

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This procedure is done with the help of a laparoscope. It is a thin, flexible tube with a camera at the end.

The surgery is done through the following steps:

1. The anesthesiologist will administer general anaesthesia to prevent any pain or discomfort during the surgery.
2. The surgeon will then make a small hole in the abdomen near the belly button.
3. Gas is filled to inflate the abdominal cavity. Generally, medical-grade carbon dioxide gas is used for this purpose.
4. He then inserts a laparoscope to view the internal organs. Once the site of surgery is identified, the doctor then makes a few small incisions.
5. The doctor then inserts different surgical tools to remove the uterus.
6. The surgeon removes the uterus in small parts through small incisions. In some cases, the doctor may also remove the small arts of the uterus through the vagina.
7. After the removal of the uterus, the doctor closes the incisions and covers them with bandages.
8. The patient may be discharged on the same day or one day after the surgery.
9. The recovery is fast with laparoscopic hysterectomy as compared to abdominal hysterectomy.

What to expect before surgery? 

1. Before surgery, the surgeon may advise you to go through some tests to check the presence of cancer in the body of the patient. The result of the test decides the type of surgery that is being used by the surgeons. Following tests are needed to be done before surgery. 
2. PAP Test: It is also known as cervical cytology. It determines the presence of abnormal cells in the cervix.
3. Endometrial biopsy: This test is done to detect the presence of any cancerous cells in the uterine lining. It is done to confirm endometrial cancer.
4. Pelvic ultrasound: This test helps detect the fibroids present in the uterus. It also helps in estimating the size of fibroids. In addition, it is done to check for ovarian cysts and endometrial polyps.

What to expect on the day of surgery? 

1. The doctor may ask the patient to follow the following instructions before the surgery starts.
2. The doctor may ask not to smoke, drink, or eat after midnight of the day before surgery. 
3. Doctors may ask you to remove jewellery from your body before the operation.
4. You will be asked to wear loose clothes. Usually, the hospital provides a gown to wear in the operation theatre.
5. Wear low-heeled shoes as they will help in balancing yourself. You may feel drowsy from the effect of anaesthesia and may feel unsteady on your feet. 

What to expect during surgery?

1. The procedure is performed under general anaesthesia.
2. However, anaesthetic techniques can vary from each other.
3. The operational procedure may take around 90-95 minutes.
4. First, a tiny cut is made near the belly button by the gynaecologist.
5. An instrument is inserted through this cut.
6. Gynaecologists insert surgical instruments through these cuts.
7. A telescope is also inserted to see inside and guide the surgeons during the operation.
8. The surgeon may need to insert the device through the vagina to remove the uterus.
9. The patient is connected to the ECG machine, which continuously tells the heartbeat and heart rate of the patient to the surgeons. 

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What to expect after Surgery?

1. You can expect the following things:
2. Soreness around the cuts
3. Pain in your shoulder is caused by pressure from the gas in the belly
4. You will be given pain-relieving medications. Make sure you have someone to take you back home.
5. You can return to your regular activities within two to four weeks depending on your recovery.

First follow up appointment

Your first follow up appointment will be around two to eight weeks after the surgery to assess your healing and recovery.

What to expect after surgery? 

Immediately after the surgery, the patient is sent to the restroom and asked to rest there for some time. The staff will monitor the signs of pain. Doctors will provide medicines for reducing pain and preventing infection. The doctor will ask you to use a sanitary pad for vaginal bleeding for a few days. 

First follow-up appointment

The patient can go home once the gynaecologist certifies that the patient is fit and fine. It is generally either the same day or the next day of the surgery. The patient is asked to rest for two days, and then they should start following the exercise routine as prescribed by a doctor. You can resume work once the doctor certifies that you are fit to go for that, depending upon the type of work that you do. You can return to work generally after 4-6 weeks. After 2-3 months, you will start feeling back to normal depending upon your job sector and daily routine.

Piles are swollen blood vessels in the rectum, a fistula is when the anal region and the skin form an irregular canal, and fissures are cuts in the anal lining. Therefore, the common symptoms of piles, fissures and fistula are:

It is crucial to identify these symptoms immediately and consult your nearest doctor for immediate treatment. If you notice any of the symptoms, please seek help from your Doctor.

When to Consult a Doctor? 

1. Immediately consult a doctor if there are any following signs and symptoms. 
2. If the pain is not reducing even after using the medicines
3. A persistent cough that does not go away.
4. If you are experiencing difficulty in drinking and eating
5. If you have continuous bleeding from the vagina that is not normal
6. If you have swelling and redness in one of the legs
7. If you are unable to urinate or feeling pain during urination
8. If you are having difficulty in breathing
9. Persistent fever above 100.50F
10. Bleeding
11. Infection 

दिनों या हफ्तों के लिए, रोगी को निम्नलिखित बातों का पालन करना होगा:

1. उन्हें सर्जरी के बाद आई ड्रॉप का इस्तेमाल करना होगा। इन बूंदों का उपयोग करने के लिए डॉक्टर के निर्देशों का पालन करना सुनिश्चित करें।
2. साबुन या पानी सीधे आंखों में जाने से बचें।
3. आंखों पर रगड़ें या दबाएं नहीं। डॉक्टर उन्हें अपनी आंखों की सुरक्षा के लिए चश्मा या ढाल पहनने के लिए कहेंगे।
4. सोते समय उन्हें एक सुरक्षात्मक आई शील्ड पहननी होगी।
5. वे डॉक्टर मरीज से बात करेंगे कि सर्जरी के तुरंत बाद वे कितने सक्रिय हो सकते हैं।
6. वे रोगी को बताएंगे कि वे कब सुरक्षित रूप से व्यायाम कर सकते हैं, गाड़ी चला सकते हैं या अन्य गतिविधियाँ फिर से कर सकते हैं।

पहले अनुवर्ती नियुक्ति

रोगी की आमतौर पर अगले दिन डॉक्टर के साथ अनुवर्ती परीक्षा होगी।

सर्जरी के बाद, आपको रिकवरी रूम में भेज दिया जाता है। उसके बाद:

1. आपको रिकवरी रूम में १५ से ३० मिनट तक ऑब्जर्वेशन के लिए रखा जाता है।
2. इन्फेक्शन और दर्द से राहत के लिए आपको दर्दनाशक और एंटीबायोटिक दवाईयां दी जाती हैं।

एनेस्थीसिया से पूरी तरह रिकवर होने के ३० मिनट बाद : 

1. आपको सभी जरूरी दवाओं को लेने के लिए कहा जाता है।
2. इसके बाद इन दवाओं के इस्तेमाल के बारे में बताया जाता है जैसे : 
   1. ऑपरेशन क्षेत्र को साफ कैसे करना है
   2. आई ड्रॉप्स को डालने का सही तरीका क्या है
3. बाहरी चमक से बचने के लिए आपको धूप के चश्मे लगाने की सलाह दी जाती है।
4. आपकी आंखों में आई पैच और कवच लगाकर आपको डिस्चार्ज कर दिया जाता है।
5. घर पहुंचने के बाद २ से ३ घंटे बाद आप आई पैच और कवच को निकाल सकते हैं।
6. सर्जरी होने के बाद उस रात को आई पैच पहन के ही सोने की सलाह दी जाती है।
7. एंटीबायोटिक्स और टॉपिकल स्टेरॉइड ड्रॉप्स का कड़ाई से पालन करने के लिए कहा जाता है।
8. सामान्यतः, सर्जरी के अनुसार, एंटीबायोटिक्स को एक हफ्ते के बाद बंद कर दिया जाता है और टॉपिकल स्टेरॉइड और नॉन स्टेरॉइड को ३ से ६ हफ्ते तक चलाया जाता है।
9. हालांकि आप सर्जरी के बाद तेजी से सुधार महसूस करेंगे लेकिन इसे पूरी तरह सुधरने में ४ से ५ हफ्ते लग सकते हैं।

प्रथम अनुवर्ती नियुक्ति

अगर सर्जरी के बाद आपको कोई समस्या नही होती है तो प्रायः ३० दिन के बाद आपको फिर से बुलाया जाता है।