Nov 26, 2009
Laparoscopy proceeded to midline laparotomy + insertion and removal of uretic stents + bilateral salpingo-oophorectomy with ovarian cysts + adhesiolysis of intra-abdominal adhesions.
FINDINGS- Dense intra abdominal adhesions of omentum and colon to anterior abdominal wall and adnexae. Right ovary/cyst NECROTIC and twisted- 6cm cyst. Right hydrosalpinx. Left ovary multicystic 5cm.
PROCEDURE- GA Lithotomy position, betadine to perineal ans vaginal areas, IDC inserted. Laparoscopy-betadine prep, drape. 12mm incision intraumbilical. Careful open entry with finger dissection of omental adhesions. 12mm blunt port inserted. Laparoscopy- unable to see ovarian cysts, dense adhesions to anterior abdominal wall. Decision for Laparotomy. Insertion of ureteric stents- cystoscopy and insertion of bilateral ureteric stents. IV gentamicin given IDC re-inserted. Laparotomy- midline incision. Opening of sheath and mesh. Dissection of bowel and omentum from underside ofmesh, and also from right ovarian cyst- extensive adhesiolysis. Right ovary and cyst mass untwisted. Peritoneal washings taken for cytology. Right ovary/cyst/tube clamped, cut and suture with 1 vicryl. Both specimens sent for histology. Wash. Satisfactory haemostasis. Omental biobsy for histology. Difficult to assess if any lymphadenopathy or perioneal disease due to bumpiness of adhesions and mesh. Mesh/sheath mass closure with 1 nylon (loop). 1 vicryl interrupted to subcutaneous layer. 3-0 moncryl subcuticular, dressing applied. Ureteric stents removed. Tips complete. EBL=250ml
So there it is, no wonder I have been in so much pain, and hate to think of what the outcome could have been, if I didn't persistantly go to hospital. With a necrotic ovary, which means dead, and like gangrene, anything could have happened. I still haven't recieved the results of biopsies, but surely I've had my fair share of health problems.