Laparoscopic Oophorectomy – Procedure and Risks

Oophorectomy is a surgical procedure to remove your ovaries. When you have one ovary removed, it’s called unilateral oophorectomy. Removal of both ovaries is called bilateral.

This procedure may be used to treat:

Pelvic inflammatory disease
Chronic pelvic pain
Ectopic pregnancy
Benign tumors
Large ovarian cysts

Preparation for Oopherectomy:
Before surgery, the doctor will order blood and urine tests, and any additional tests such as ultrasound or x rays to help the surgeon visualize the woman’s condition. The woman may also meet with the anesthesiologist to evaluate any special conditions that might affect the administration of anesthesia. A colon preparation may be done, if extensive surgery is anticipated.

On the evening before the operation, the woman should eat a light dinner, then take nothing by mouth, including water or other liquids, after midnight.

What happens during the procedure?
Oophorectomy is done under general or regional anesthesia. It is often performed through the same type of incision, either vertical or horizontal, as an abdominal hysterectomy. Horizontal incisions leave a less noticeable scar, but vertical incisions give the surgeon a better view of the abdominal cavity. After the incision is made, the abdominal muscles are stretched apart, not cut, so that the surgeon can see the ovaries. Then the ovaries, and often the fallopian tubes, are removed.

Oophorectomy can sometimes be done with a laparoscopic procedure. With this surgery, a tube containing a tiny lens and light source is inserted through a small incision in the navel. A camera can be attached that allows the surgeon to see the abdominal cavity on a video monitor. When the ovaries are detached, they are removed though a small incision at the top of the vagina. The ovaries can also be cut into smaller sections and removed.

The advantages of abdominal incision are that the ovaries can be removed even if a woman has many adhesions from previous surgery. The surgeon gets a good view of the abdominal cavity and can check the surrounding tissue for disease. A vertical abdominal incision is mandatory if cancer is suspected. The disadvantages are that bleeding is more likely to be a complication of this type of operation. The operation is more painful than a laparoscopic operation and the recovery period is longer. A woman can expect to be in the hospital two to five days and will need three to six weeks to return to normal activities.

Post OP Care :
After surgery a woman will feel discomfort. The degree of discomfort varies and is generally greatest with abdominal incisions, because the abdominal muscles must be stretched out of the way so that the surgeon can reach the ovaries. In order to minimize the risk of postoperative infection, antibiotics will be given.

When both ovaries are removed, women who do not have cancer are started on hormone replacement therapy to ease the symptoms of menopause that occur because estrogen produced by the ovaries is no longer present. If even part of one ovary remains, it will produce enough estrogen that a woman will continue to menstruate, unless her uterus was removed in a hysterectomy. To help offset the higher risks of heart and bone disease after loss of the ovaries, women should get plenty of exercise, maintain a low-fat diet, and ensure intake of calcium is adequate.

Return to normal activities takes anywhere from two to six weeks, depending on the type of surgery. When women have cancer, chemotherapy or radiation are often given in addition to surgery. Some women have emotional trauma following an oophorectomy, and can benefit from counseling and support groups.
Tell your doctor right away if you:

develop a fever
have nausea or vomiting for more than a few days
have more vaginal discharge or bleeding than expected
have abdominal pain that doesn’t improve with medication or is getting worse
develop redness or swelling around the incision site
have trouble urinating
are coughing, or have shortness of breath or chest pain
feel depressed
Side effects  & Risk :
Allergic reaction to anesthesia
Blood clots
Damage to nearby organs
If both ovaries were removed, you’ll likely have symptoms of menopause due to the drop in your levels of estrogen and progesterone. Many women are placed on hormone replacement medication.

Symptoms of menopause may include:
Hot flashes
vaginal dryness
changes in sex drive
sadness, anxiety, depression
Menopause also means an end to menstruation and the need for birth control.

Serious complications after oophorectomy are rare, but you may be more prone to complications if you have diabetes, are obese, or are a smoker. Report unusual side effects to your doctor right away.

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