What to Expect During Laparoscopy
What will I experience when I arrive in the operating room?
From the pre-operative area, you will be taken to the operating room in a gurney. The nurse and anesthesiologist will take you into the room. Dr. Willman will be already in the room waiting for you.
You will be given medication through the IV to help you relax. It can also give you amnesia, so you may not remember anything after arriving to the operating room.
There will be lots of equipment in the operating room:
- An anesthesia cart that will give constant measurements of your pulse, blood pressure and oxygenation.
- Flat-screen monitors on which the operation is viewed by the surgeon, her assistant and the nurses.
- The Da Vinci patient cart that is the “robot” that holds the instruments.
- The Da Vinci surgeon’s console about six feet from the procedure table where Dr. Willman will sit and control the instruments.
- A tall tower or cart that houses the computer and controls for different instruments.
- Operating room lights that are suspended from the ceiling
- There will also be computer screens where Dr. Willman can view your electronic medical chart and any medical imaging tests such as an MRI or ultrasound.
You be asked to move yourself from the gurney to the procedure table. Stockings will be placed on your legs. These stockings pump up and down every few minutes. They help the return blood back to your heart and greatly reduce the risk of having a blood clot during or after surgery. When you wake up in the recovery room, the stockings will still be on.
The anesthesiologist will give you oxygen to breathe through a mask. Then you will receive medication through the IV that will put you to sleep. You should not remember anything else. When you wake up, you will be in the recovery room and your operation will be over.
What happens while I am asleep?
- Once you completely asleep, the anesthesiologist will put a tube down your airway to control your breathing. You will also have a tube placed into your stomach to empty the stomach fluid during the operation.
- Then, your legs will be placed in stirrups (these are supports that hold your legs bent and apart, much like how you are positioned for a Pap smear).
- Your arms will be tucked to your side.
- We then do a “tilt test:” the bed is tilted 45 degrees so that your head is down & your hips are up. Dr. Willman will watch you in this position to make sure you do not slide down the bed. If there is any concern that you will slide, then “shoulder bolsters” are placed at the shoulder to keep you from sliding. Once the “tilt test” is done, the bed is straightened out. The nurse will then clean your abdomen and vaginal area to prepare for the operation while Dr. Willman washes her hands & arms.
What exactly happens during the operation?
- After the skin has been cleaned, sterile drapes are placed to cover all areas except those in which the surgeon needs access.
- A tube is placed through the urethra, into the bladder and drains urine into a collection bag. This allows continuous drainage of the bladder. This is important because it reduced the risk of injury to the bladder during surgery. This also gives the surgeon & the anesthesiologist information about your hydration and kidney function during the surgery. Typically this “foley bag” is removed at the end of the procedure and before you wake up.
- Often a stiff catheter is placed in the uterus. This is can serve several purposes: a blue dye can be instilled inside the uterus and can be used as a landmark to let Dr. Willman know if the uterine cavity was entered during the dissection of a fibroid. The blue dye can also be pushed through the fallopian tubes and is used to confirm that both fallopian tubes are open. Sometimes the catheter is also used to shift the position of the uterus during the operation to make access to certain areas easier.
- Dr. Willman will use a local anesthetic at the skin incision sites. This has been shown to reduce pain after surgery.
- Four to five skin incisions are made, 8 to 12 mm in length. Through these incisions, metal tubes called “ports” are placed. Once all ports are placed, the Da Vinci patient cart is brought up to the procedure table and the “robot” arms are secured to the ports.
- Dr. Willman will then sit at the surgeon’s console and operate.
- After the operative procedure using the Da Vinci is completed, Dr. Willman will come back to the operating table. The instruments and ports are removed. More local anesthetic is placed at the incision sites. Stitches are then placed to bring the incisions back together for healing.
- You will then be awakened in the operating room. The breathing tube, the foley catheter and the uterine catheter will be removed in the operating room and you will then be taken to the recovery room.
- When you wake up in the recovery room, you will still have the IV in place. You will have the leg stockings on. And you will have a mask giving you extra oxygen.
What will I remember?
Most patients remember going in to the operating room. The next thing they remember is being in the recovery room.
Dr. Willman will be there in the recovery room with you. She will talk to you and ask you if you have any pain or nausea. She will reassure you about the operation. You may not remember any of this because of the anesthesia medications.
After you are admitted to the recovery room, Dr. Willman will call your family member or friend to give them an update on how your are doing.