lapascopic ovarian cystectomy

[duff0015]

Hi there,

I have a suspected 3.4 cm endometrioma on my left ovary (have posted before) and am scheduled to have it removed in early August.  I am 32 yo and for the most part, in good health.  I have had a few surgeries, all outpatient under MAC sedation, local and epidural (vaginal delivery).  I am anxious about general anesthesia and the risks associated with a lapascopy.  I hate reading that death can occur...  I know, I have control issues so surgery is a big deal to me.  

What are the risks (including death) associated with the procedure?  What can I do as a patient to minimize risks?  With all lapascopic surgeries, do you have to consent for a conversion to a laparotomy?   Can my gyn onc safely remove a cyst of this size without rupturing?  I am nervous (about this too) about it rupturing if it is malignant (docs seems to think most likely not).  

Thanks so much for helping me with all this.  I really do appreciate it.  You are truly a gifted doctor and caring spirit to help others on this board.  We all appreciate it.  

take care,
Donna

[Annekathryn Goodman, M.D.]

Dear Donna,

I just did a Google search of laparoscopy. There is alot of information out there! If you type laparoscopy, anesthesia you will come to many sites that you can browse.
But the bottom line is that laparoscopic surgery is routine and safe. It requires general anesthesia. It is just too uncomfortable otherwise. Also it is not safe to do a scope under local (there is experience with **** very quick and focuses surgeries such as tubal ligation under local.)

It is important to protect the airway (which means the lungs) by placing a breathing tube into the trachea (windpipe). That way, a person is constantly getting oxygen and the airway is protected from stomach contents going into the lungs (which is called aspiration).

It is rare to convert from laparoscopy to laparotomy for a 3-5 cm cyst. However, one does not know completely what is going on inside until surgery. it is important to have a good preop operative discussion of all the possibilities.

I understand your fear. we all have control issues!  You have been through alot !
best wishes

ps thank you for your kind words!

[duff0015]

Sorry to sound so dramatic.  I know I am a chicken and always have been with things out of my control.  So when I lost both parents a few years back and got stage 1 breast cancer a little over 6 months ago, it just intensified my fear.  I worry about my little girl.  Thanks.  

[chapter11]

I want to second Donna's comment about Dr. G being truly gifted.  I've never encountered a doctor quite like her!