surgery options,help please?

[lola560]

Hello,I would like to find out if it is possible to have surgery to remove a 4cm dermoid cyst from the ovary,under epidural/spinal or regional anaesthesia instead of general.If not possible could you please tell me why?
Many Thanks

[Annekathryn Goodman, M.D.]

Hi There

it depends on how surgery is planned

If you are going to have an incision which is called a laparotomy, then epidural is a safe option.
In fact epidural anesthesia is used routinely for a cesarean section which is the same kind of incision.

However,if you or your surgeon wants to perform the surgery using a minimally invasive technique called laparoscopy, epidural anesthesia by itself is not safe.

to perform a laparoscopy which involves at least 3 tiny incisions in the abdomen,
the abdomen has to be distended with carbon dioxide gas and the patient has to been tipped on their head to push the bowels out of the way.
it is important to protect the airway from stomach contents that can reflux up the esophagus and into the lungs , therefore the patient needs to be intubated so the lungs are protected.

secondly it is not possible to fully control the pain of abdominal distension by epidural or spinal alone.

I hope all works out
best wishes

[lola560]

Hi Doctor,
Thank you very much for your valued answer.It is very helpful to receive a personal answer from someone with so much experience and who is so well qualified.You provide a wonderful service,
Many knid wishes and blessings to you.