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Removal of Tubes by the Closed Method

Laparoscopic Bilateral Salpingo-Oopherectomy (Removal of closed ovaries and tubes)

Bilateral Salpingo-Oopherectomy (BSO) is the surgical removal of both fallopian tubes (salpingo-) and ovaries (oophorectomy).

Laparoscopic BSO, on the other hand, is the removal of the ovaries and fallopian tubes through a small hole. Laparoscopic surgery provides earlier recovery than open surgery. (You can find detailed information about laparoscopy from the menu)

Laparoscopic Bilateral Salpingo-Oopherectomy

Management of perimenopausal women with ovarian cysts (if ovarian masses) In the pain management of women with endometriosis (chocolate cysts), GnRH injections have proven to be beneficial and are very painful. To prevent the onset of cancer in women who are at high risk for ovarian cancer as a result of genetic predisposition (BRCA 1/2) or who are at high risk for breast cancer in association with hormone use

What happens during Laparoscopic Bilateral Salpingo-Oopherectomy?

Laparoscopic Bilateral Salpingo-Oopherectomy is a common surgical procedure; It routinely takes 40-60 minutes. The procedure is performed while asleep under general anesthesia. The procedure is performed laparoscopically, that is, through a small hole. It is a procedure in which a camera called a laparoscope is passed into the abdominal cavity. Two or three incisions, approximately 1 cm long, are made in the abdominal wall. The ovaries and fallopian tubes are identified and disconnected; Then it is taken out from one of the incision sites.

If you are not in menopause, removing your ovaries will put you through menopause, and you may need hormone replacement therapy, also known as HRT. This issue will be discussed with you before the surgery.

It is very important that you are not pregnant during the surgery. You should continue to be protected with a reliable method of contraception until the surgery is completed. If you are not in menopause, a pregnancy test will be performed at the time of application. PLEASE NOTE THAT THE NEGATIVE PREGNANCY TEST DOES NOT EXCEED EARLY WEEKS PREGNANCY AND INFORM YOUR DOCTOR OR NURSE IF YOU SUSPECT THAT YOU MAY BE PREGNANCY. Your procedure may be delayed until pregnancy is excluded or you have menstruation.

What are the benefits of this process?

Some conditions listed above may require removal of the ovaries-tubes for treatment. After the procedure, you will no longer have menstruation. With the closed method, faster recovery and recovery are seen after the operation, because major surgical procedures in which the abdominal cavity is opened during the procedure are avoided.

Are there any risks associated with this transaction?

As with all surgeries, there are always various risks in this procedure, but these are rarely seen. Some of them can be seen during the operation, while others are seen after the operation, after discharge.

Infection: There is a risk of infection with every invasive procedure. Most infections occur in the bladder or vagina. There is also a risk of lung infection if you smoke or have a lung condition. Another area of ​​infection is wound sites; this manifests itself as redness at the wound site or as discharge from the wound. Your fever and other observations will be monitored regularly as indicators of infection.

Bleeding: In addition to vaginal bleeding, there is a risk of bleeding into the abdomen of some blood vessels whose ends are sealed during tube and ovaries removal. This bleeding can occur during or immediately after surgery. If this condition is severe, you may need a blood transfusion or, in very rare cases, you may be taken back to the operating room to stop the bleeding. A tube called a drain can be placed in your abdomen to monitor for bleeding into the abdomen.

Intestinal or bladder damage: Due to the anatomy of the pelvis, there is a slight risk of injury to the bladder, ureters (tubes connecting the kidneys to the bladder) or intestines. Because all of these structures are located very close to the uterus. In particular, if you have a risky condition such as having undergone previous surgery, you will be informed about this. If there is any problem, it will be handled appropriately and you will be informed after the surgery.

Adhesions and Hernia: Almost all patients undergoing abdominal surgery develop adhesions; which is scar tissue that can cause the intestines to stick together. Normally these do not cause any complaints; however, they can sometimes cause pain and problems with bowel function. Hernia, on the other hand, is a damaged herniation area that can develop at the wound site, which may need to be corrected by surgery, but this is very rare because the operation incisions are very small.

Coagulation: Major surgery is a risk factor for developing a blood clot in your legs, which can lead to deep vein thrombosis, known as DVT, or a pulmonary embolism in your lungs. You will be evaluated for your risks and recommended to wear anti-embolic stockings until you are fully mobile. An injection will be made into your abdomen to prevent clotting.

Processing some patient-related ailments

Pain/Delayed bowel function: Bowel functions can sometimes be affected, causing pain felt in the abdomen, shoulders and neck. This situation can be corrected by consuming a small amount of food and plenty of water and starting to move as soon as possible. Sometimes the bowels stop completely, which is ileus and causes pain, bloating, vomiting and constipation. If ileus develops, you should not eat anything and very little water should be consumed until it resolves.

Constipation: It may take some time for bowel functions to return to normal. Laxative drugs may be recommended.

Bloating: You may feel bloated after surgery, or your tummy may look bloated. This is due to the remaining gas. It can irritate your diaphragm and cause shoulder pain. It will improve over time, but painkillers can be used.

Urinary tract complaints: You may feel the need to urinate more frequently after surgery, and this may be painful. It is usually due to the damage of the inserted catheter to the bladder. Painkillers can be recommended and if it does not heal, a test for infection may be requested.

Are there any alternative methods to Laparoscopic Bilateral Salpingo-Oopherectomy?

There may be various alternative methods, depending on the reason for treatment. These methods include a drug called Zoladex. Zoladex is an injection administered every 6 months and turns off the ovaries' capacity to produce estrogen (the main hormone produced in the ovaries).

An alternative surgery such as open technique (by cutting the abdomen) Bilateral Salpingo-Oopherectomy may be offered. With this procedure, a larger incision is created in the abdominal wall. With this incision, the ovaries and fallopian tubes are taken out. Post-procedure recovery time is longer. The risk of infection is higher than the laparoscopic method, but the risks of organ damage are similar.

What else do you need to know about the procedure?

Removal of the ovaries: If you are still menstruating, removing your ovaries will cause you to enter menopause. You may experience this as hot flashes, night sweats, vaginal dryness (which can cause pain and discomfort during sexual intercourse). You may also experience mood swings, fatigue, anxiety, dry hair and skin, as well as joint pain. Long-term estrogen deficiency can cause osteoporosis (thinning of the bones) and heart disease.

Hormone Replacement Therapy: It alleviates the symptoms and side effects of menopause. It replaces the estrogen formerly produced by the ovaries. It can be used as a tablet, skin patch or gel. This will be discussed with you before the operation.

Back to work: While recovery time varies from person to person, returning to work depends on your job and whether you can cope. You should stay away from work for 2-4 weeks. After the surgery, your doctor will discuss this with you.

Driving: Before you can drive again, you must regain the strength necessary to deal with an emergency. You should feel comfortable sitting with the seat belt on your stomach. Sources suggest that it should take 4-6 weeks before driving. You should check your insurance.

Sexual activity: It is recommended to abstain from sexual activity for at least 4 weeks. This approach prevents infection and reduces trauma. However, the continuation of sexual intercourse can be consulted with the team in charge or at your follow-up appointment.

Follow-up appointment: You will be informed about the follow-up appointment after discharge. If your surgery went well and was performed for a benign reason, a follow-up appointment will not be given. The pathology results of the samples taken during the surgery are sent to your surgeon, who can contact you.

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