cystectomy

Hi: I'd just heard on our medhelp about a cystectomy, what is that? I have a right ovary that is nearly covered with a cyst, I'm post menopausal and they are wanting to take the cyst out.

[outdoorsgirl]

cystectomy = removal of cyst from ovary. The ovary is not removed. Usually the option given to younger women who want to preserve fertility.

oophorectomy = removal of affected ovary and tube. Usually the procedure recommended to women past a certain age (45?) where there is less concern about fertility (and more concern about cancer).

[janepm]

Hi: thanks for this, I know I asked the oncologist/gyn last week about the first one, he said that if it is cancerous, it could make the other organs "angry" and spread the cancer.

On the second one, tell me more about this, is the surgery the same, the healing, etc.? And how about if cancer is there, what about the lymph nodes and all whether cancer is there or not?

[outdoorsgirl]

Your oncologist's comment is why they prefer to take the ovary in older women. The surgery would be the same, recovery the same. Just depends if it is laparoscopic or a laparotomy. If it is cancer and the oncologist is doing the operation, I think he may do more at the time, but you would have to ask him or ask the experiences of the women on the ovarian cancer forum.  

[MarieMichele]

All gyn/onc's go into surgery believing they will find cancer even if they don't.  They are programmed to think that way.  It's their surgical expertise that we want, even for the benign cysts.  They know how to remove only what needs to be removed without damaging things all around it.

My gyn/onc made sure I was prepped for possible major surgery, cancer treatment, etc., etc.  He only found one benign cyst and removed both ovaries/tubes with it.  He did a full exploratory, checked the liver, bowels, kidneys, etc., and found everything was healthy and cancer free (yay!)  They do a "wash" of the parts and it tells whether cancer is present or not.

He wanted to be sure he could attack anything bad he might have found, that he could remove the cyst intact and undisturbed (unruptured), so I was automatically scheduled for and had a laparotomy.  

This is what I chose after carefully discussing the options with the gyn/onc/surgeon.  He spent HOURS with me during that pre-op consult and most good doctors will do just that.

That doesn't mean you have to have this type of surgery.  You could easily just have this removed by laparoscopy.  

Very little attempt is made to save an ovary for post-menopausal women, so I would think the minimum they would do is remove the cyst and one ovary/tube if benign.  If not benign or borderline, then certainly both ovaries would be removed and any surrounding parts that appear to be affected.  This is rare so try not to think of this as a possibility.  

You could take the option that I took to have both ovaries/tubes removed to prevent the remaining ovary from becoming cystic in the future.  My gyn/onc felt strongly about taking out both based on his experience with post-menopausal women.

It seems to be the type of incision that determines how long of a recovery rather than what is done internally.  Laparoscopic incisions are smaller and heal faster (approx. 2 weeks).  Laparotomy requires a minimum recovery at home of 6 weeks, but most will still be a bit sore beyond 6 weeks.

This is NOT an easy decision to make and I do not want to ever force my ideas on anyone, just explain the process by which others like myself have reached decisions prior to surgery.  I am happy with my decision even though I was so frightened of surgery, I think I could have died from fright alone.  Happily, though, I survived!

[janepm]

you are certainly a godsend to me and others here, I appreciate it and I really value your opinion and experience. I will be having my pre-op the day before with the PA who will be there in surgery, I suppose it is ok to discuss all of this then or should I make another face to face with the Oncologist/GYN to discuss more of my questions, I had told them a lap with one ovary removed, I didn't know if the day before was too late to ask for more given extra time to do anything?

Thanks! Oh he is doing the Da Vinci and said he would be making around 5-6 small incisions around my belly button.

[MarieMichele]

My own surgeon had a PA who I met the same day I met my surgeon.  My situation is a bit different.  I met the surgeon and PA on a Tuesday for the first time and asked all my questions then.  The PA spent time with me regarding my medical background.  The surgeon spent time with me regarding what type of surgery was going to be chosen.  Once a decision was made, scheduling with the hospital was made by phone.

Their offices are attached to the hospital, so they sent me for pre-op tests that very same day, Tuesday.  Wednesday was my last day at work and Thursday was my pre-op preparation day on laxatives, so there is no way I could have gone out to a doctor's office on the day before the surgery. That is where we differ...how will you be meeting doctors the day before surgery if they need to get you started on preparation (laxatives) or is your plan a bit different?  If you think your questions/answers might lead you to change your mind on the type of surgery you want done, you would need to meet with them sooner than the day before scheduled surgery.

I was in the hospital for the surgey on a Friday and released the following Monday.  Over the weekend, the PA visited me in my room.  I only saw the surgeon immediately before and immediately after surgery.  He did tell me that I wouldn't see him over the weekend since those were his days off and was willing to schedule the surgery to mid-week the following week if I wanted him around the whole time.  But to get it done at the earliest possible time (doctor's preference), I had the surgery on Friday with a weekend stay in the hospital.

My surgeon specializes in the Da Vinci technique as well, but for me he preferred open surgery with a full incision.  I guess the pre-op has to be different if you are meeting with them the day before and I was stuck at home with frequent bathroom visits (not fun, but necessary) instead.

With the Da Vinci, you will probably have a shorter hospital stay than I did.