Laparoscopy - with local anesthesia?

[vienna_h]

Is it possible to perform a laparoscopy to remove an endometrioma cyst (4cm) with only local anesthesia?

[Pierce2017Tim]

My mom had one ovarian cyst the size of a grapefruit at the age of 88 and put into a care facility to monitor and care for her.  Doctors said it was too risky to remove the cyst and was possibly cancerous.  Months later the cyst grew very large and her belly looked pregnant with the belly button protruding outward.  My mom being 4'10 and 100 lbs was in a precarious situation. A doctor said if it were his mom he would give her more morphine and let her go peacefully.  That option was off the table as far as I was concerned.  The other option was general anesthesia and surgery. But that too was very risky and would have likely ended up with mom not waking up from surgery with her condition the way it was added was congestive heart failure.  So I pressed and would not relent in the only option I felt she had a "chance for life" and that was local anesthetic.  They had not done this type of surgery on such a critical patient and that was this old.  
So they eventually relented and I signed many papers of liability releases as they initially drained the cyst of 1.5 liters of fluid from the one ovary. There was still fluid left but they ended up removing it as she was under local anesthetic for 1.5 hrs of surgery.  The recovery from O.R. was less than 10 minutes and was back in her ICU room at the hospital recovering.  There was a journal written up about my mom and the drastic procedure done on elderly patients. My mom was a first at the Santa Rosa Memorial Hospital and had "the whole hospital a buzz".  My moms doctor and anesthesiologist were fantastic, as they pulled off a very risky surgery with local anesthetic.  My mom Debbie is going on 92 years old this November. :-)

[old_before_my_time]

Wow Pierce2017Tim what an amazing story! Good for you for fighting for your mom! So I assume the cyst was benign / non-cancerous? Do you have a link to the journal article of her case? I'd be interested in reading it.

Thank you for sharing this wonderful story.

[talena828]

i am supposed to have laparscopy done this thursday , i'am scared , i don't due well with being put to sleep , i get really sick and it takes me an while to get over the sleepy drug feeling , plus , my doc wants to due it without an recent pap smear , i am so nervous , plus the fact the i have family history of endo , fam history of cervical an ovarian cancer , what should i do

[brines963]

I also deal with anxiety, and take Xanax as necessary.  I told the anestheogist that I was like that, and they put something in my IV that really, really helped...I think it is called Versed.  Ask for it...they don't want you to be nervous, and in my experience, they really wanted to make it as easy as possible for me.  

[vienna_h]

I normally take clonazepam (or other benzo) for my anxiety, I wonder if it is possible to take something similar before surgery. I imagine the moment when I have to be put under and I just don't see myself doing it, I have a true phobia, I would sooner jump out an airplane than consent to be put asleep and leave my life in someone else's hands. I've always thought surgery was the scariest senario I could imagine, never thought I would actually have to go through it.

[vienna_h]

The top 10 thread and others have helped me feel a bit more prepared about surgery, but also scared of complications. I can't imagine waking up and finding out I lost an ovary or finding a midline scar, I would simply want to die, honestly.

I saw one doctor (I saw a second one for a second opinion) she wants me to have surgery immediately and says it must be with general anesthetics because the CO2 gas would push on my diaphram and make it to difficult to breath on my own.

I saw the second doctor, who is affilitaed with McGill University where I am an alumna, he ordered another ultrasound and didn't want to talk about anything until those results came back. I didn't like getting brushed off so quickly but I know he is a leader in the field and has published several highly-cited journal articles regarding cysterectomy prodecures and endometriosis, so he is a better doctor than the first one. And he insist I had a ultrasound by the "best doctor" (he didn't trust my other US and MRI results from my local hospital) so I think its worth waiting for his opinion.

Part of me is happy to post-pone surgery and wait for mor test results, but part of me knows surgery will be inevitable and I just want to get it over with and stop being so scared... I want to be normal and healthy again :(

[Cookybee]

Hi

I had my surgery on 16thjanuary 2011. Like you I was scared about having the general anesthesia.I have a thing about needles

the nurse talked to me while they were setting very thing up and I was so nevous that my doctor came to talk to me before they put me under.they gave me the mask to put on and after about two deep breathes I was asleep.
If you are that afraid you should talk to the doctor they might give you something to take before to going  to theatre. It's really not that bad.
I would not have a local anesthesia I wouldn't like to know what was going on but that's just me.

as regards scars I have three little ones two on my bikiki line and one on my belly button which it is so small you cann't even see it.

I found that the more information i had the more I could put my mind at rest.
I found this site and it has help alot.any of the questions that I thought were silly were mostly answered on here.
I found the 10 things you need to know about Laproscopy really helped.

Hope this helps
good luck and keep us posted on how your doing.

bye cookybee

[vienna_h]

Thank you for answering!

Is it really necessary to remove it? And must this be done as soon as possible?

I am scared to death about general anesthesia (I have an anxiety disorder) and honestly, I don't know if I can consent to the operation. Could this be a valid reason for local or regional anesthesia?

I'm also afraid of possible damage caused to my reproductive organs, and wondering if the benefits outweigh the costs of surgery?

And lastly... how does a 4cm cyst come out of a 1cm incision? Will I have scars??

[Sanjivani Wanjari, MD]

HI  vienna_h,
Removal of an endometriotic cyst is necessary as there is a chance that it will grow in size and progression of the disease process may affect fertility in the long run. Ideally the laparoscopy should be done under general anaesthesia in order to avoid complications and also for patient comfort.
Hope this helps.