Ovarian Cyst Surgery; Laparotomy: Part I

In this post I will share my experiences of an open cut Endometriotic Ovarian Cyst surgery. Information shared by many other women has helped me during my recuperation and I hope this post can be of help to others.

 

Laparoscopy is a minimally invasive surgery whereas Laparotomy is a cut & open surgery. I had a cut & open surgery to remove a cyst over my right ovary because prior to the surgery, my tests had come positive for malignancy. Also my cyst was partly solid and quite big; 11cm X 9.5cm. In case of cancer, the surgery is not Laparoscopy but Laparotomy because the surgeon needs to inspect all the surrounding organs to check the damage and remove whatever is affected. Thus, Laparotomy gives them a better view and ease of movement. My surgery was done by Dr Hemant Tongaonkar, a Gynaecologist-Oncologist & Urologist, at Hinduja Hospital, Mumbai.

 

Post-surgery, my ovarian lump turned out to be an Endometriotic cyst and it was not cancer but the surgery that I went through was the same that someone with ovarian cancer would have gone through.

 

When I woke up after the surgery, I had severe discomfort & pain in my abdomen. I was given an instrument where I could press a button to release an immediate shot of pain killers in case the pain became unbearable. I have to admit that I pressed it many times. I was given a vertical, mid-line incision. Single thread running stitches were used to stitch me up. The sutures were dissolvable. The discomfort caused by the big incision and the surgery was very troublesome for around 2-3 days.

 

I had a nasogastric tube in my right nostril, a catheter in my urinary tract and a drain pipe on the left side of my abdomen. Medicines and food was given to me intravenously. The anaesthesia and strong antibiotics caused vomiting even though I was not taking anything from my mouth.

 

The doctor kept asking if I had passed gas. I finally passed it on the third day. When you are given general anaesthesia for a major surgery, your intestines also go to sleep. Passing gas means they are waking up and now you can be given something through your mouth. On the third day, the nasogastric tube was removed and I was given some water to drink but I kept vomiting. You may experience nausea and vomiting till the effect of the anaesthesia starts to wear out.

 

I was also given an abdominal belt to wear on the third day. This belt protects your sutures and incision from any sudden impact and injury. It also supports the internal sutures and organs. I was told that I will have to wear this belt for three months.

 

On the same day, I was also made to rise from the bed and walk a little. For support, I was given a walker. And it was still a nightmare! A nurse and my brother helped me get up but I felt so giddy that I was not even able to balance my neck. They made me sit on a high-seat sofa with back rest for some minutes and then helped me get up for the walk. When you get up on your feet for the first time after this surgery, you will feel that you are never going to walk again but hang on; it will get better each day.

 

I was unable to stand erect because of the pull and tug I felt in my abdomen. I would suggest to you that don’t force yourself to keep an erect back. It is ok. Your abdomen is wounded and weak and wants to stay curled. Let it be. With time, the posture will correct gradually. The walk that I took was exhausting even though it was a small walk. I was given thin lentil-water to drink that day. So I was started on liquid food from today.

 

By the fourth day, my vomiting had stopped but I developed diarrhoea. This was again due to the strong intravenous antiobiotics and painkillers.

 

I was given a spirometer for exercising my lungs. I was too weak to do it so the doctor said that I could start it after a few days. I then made the mistake of completely forgetting about it for a long time. If you are given a spirometer, please use it. It helps your lungs come back to their normal capacity.

 

On the fifth day, my catheter was removed. That was a relief. And removing the catheter was a moment’s job and painless. I had started taking semi-solid foods now. The diarrhoea was still on. Every time I would eat or drink anything, I would have to ‘go’. I was so scared of eating that even though I felt hungry, I would eat only a little. The doctor told me that I should not worry about the diarrhoea; it was harmless. But staying hungry was harmful.

 

There was a big crepe-bandage kind of bandage pasted across my abdomen after the surgery. This bandage helps to keep your sutures (stitches) and the abdominal muscles together. On the fifth day, this bandage was removed. My sutures were cleaned and I was given a dressing of gauge bandage and tape. Up till now, I was being given sponge baths. Today I was given a big plastic tape to cover my abdomen and was asked to take a shower. I poured water on my lower body but sponged my upper body as I was scared that some water might seep into the tape somehow. The sutures have to be kept dry so you have to be careful. I continued to have loose motions. On the fifth day, I was also given solid food.

 

By now, I was walking around without the walker. I was advised to increase my walking time and frequency which I did but did not force myself too much.

 

On the eighth day, my drain pipe was removed. After the surgery, a drain pipe is inserted in your abdomen to drain out the fluid that collects near the surgery site. This fluid keeps seeping out from the drain pipe and collects in a plastic pouch. This drain is not removed till the daily fluid collection comes down to less than 5ml. My daily fluid collection was 200ml – 180ml and reduced slowly. On the seventh day it came down to 5ml. While removing it, the doctor asked me to take a deep breath and hold it in. Once my abdomen was inflated like this, the doctor pulled out the pipe in one swift pull. It did hurt but only for that one tiny second.

 

Once the drain pipe is removed, you will feel very relieved. It is easier to go to the toilet now, to move, to walk and also to take bath. The hole from where the pipe was pulled out was immediately covered in bandage. My suture dressing was also changed. And I was given discharge in the evening.

 

This post was about the first week after the surgery. My next post will be on the period starting from second week till eighth week, ie. the two month period after surgery. This is the period that you will be spending at home. The instructions given to me for home care are also discussed in the next post, Ovarian Cyst Surgery;Laparotomy: Part II.