Total Abdominal Hysterectomy-Bilateral Salpingo Oophorectomy - Research Paper Example

Total Abdominal Hysterectomy-Bilateral Salpingo Oophrectomy Total abdominal hysterectomy-bilateral salpingo oophrectomy refers to a complete extraction of the uterus, fallopian tubes and the ovaries. The surgery is often undertaken to remove cancerous cells from the abdominal surface in order to save life and improve the quality life. Before the procedure is conducted, the patient is taken through several preparatory activities prior to the scheduled date. Seeking the patient’s informed consent and counselling is recommended before the day of the procedure. During the surgery, the patient’s abdominal surface is carefully examined before the contaminated tissues are removed. The pathologist examines the removed organs and forwards the results to the oncologist who advises the patient on the treatment. It takes the patient several weeks to recover from the procedure. The effects associated with the procedure include the risk of catching heart diseases, clotting disorders and infections. Radiation as a form of treatment exposes the patient to radioactive rays that are more dangerous to life. Total Abdominal Hysterectomy-Bilateral Salpingo Oophrectomy Introduction Total abdominal hysterectomy refers to the extraction of the uterus and the cervix while bilateral salpingo oopherectomy entails the extraction of both oviducts and the ovaries. Therefore, total abdominal hysterectomy-bilateral salpingo oophrectomy refers to total removal of the reproductive parts of a female human being. The surgical operation is normally performed by a gynaecologist. With abdominal hysterectomy, the uterus is removed through a cut in the lower abdomen. According to Kovac and Zimmerman (2007), the uterus is the baby’s porch, holding the baby as it grows during pregnancy. Complete removal of the womb translates to a woman’s inability to support pregnancy. Abdominal hysterectomy is carried out mainly because a woman experiences abnormalities in her lower abdomen, especially around her reproductive organs. Reproductive organs are delicate parts of a human body, especially among the women and as such, any discomforts felt around the area should be addressed promptly (Scott-Conner & Dawson, 2009). Difficulties in conception are experienced when there is an anomalous act with any a woman’s reproductive parts. This situation is prevalent among most women today, with research indicating that women across the globe are experiencing a rising rate of fibroids growing around the reproductive organs. In case of delayed detection and treatment of the growths, the uterus can easily be infected, resulting in either partial or total extraction of the womb. The incidence of uterine cancer amongst middle aged women has been on the rise, leading to more cases of total abdominal hysterectomy. When bilateral salpingo oopherectomy is carried out, a woman is left with no fallopian tubes, halting the release of ready ova for fertilization. This procedure is normally conducted when the ovaries are malfunctioning. Doctors and physicians normally advise for removal of ovaries when they detect cancers which usually interfere with a woman’s hormonal balance (Pudner, 2005). Several negative impacts are associated with removal of ovaries, which include heart disease and breast cancer. The main purpose of total abdominal hysterectomy-bilateral salpingo oophrectomy is to save lives and to promote a woman’s quality of life by having the cancerous tissues around the abdomen removed. Discussion Total abdominal hysterectomy-bilateral salpingo oophrectomy is a very delicate surgical operation that requires full attention of experts. Several activities are involved prior to, during and after the procedure. Pre-operation activities involve preparing the patient to go through the process while in a state of total relaxation. A patient undergoing total abdominal hysterectomy-bilateral salpingo oophrectomy must be admitted in hospital a day prior to the actual day of the procedure. Consent must be obtained from the patient before the operation is conducted. This is crucial to ensure the patient’s willingness to assume the potential risks of the operation, including the possibility of death (Pudner, 2005). Since the procedure is irreversible, the immediate family members must be consulted unless the patient is in a position to make informed decision on her own. Counselling services are important during this period to encourage the patient and assure them that the procedure is generally safe and beneficial for their own wellbeing. Every patient fears to undergo a surgery, but with assurance that many people have gone through the various procedures safely, they gather the courage to undergo the operations (Scott-Conner & Dawson, 2009). The immediate family of the patients are also taken through a therapy session where they are prepared on the likely outcomes of the procedure and how to treat the victim afterwards. The patient will be expected not to take anything by mouth 5–8 hours before the scheduled time of the surgery. The patient gets a chance to be taken through the mode of anaesthesia that will be used by an anaesthesiologist. Several diagnostic examinations are carried out with the directions from a physician, including urinal analysis and blood count before the administration of pre-procedural medication (Pudner, 2005). The patient is also instructed on the mode of dressing while in the operation room where she is expected to do away with any artificial material on her body like jewelleries, make up and contact lenses. About an hour to the scheduled time, the patient is taken to a room near the operation area where she will shave her reproductive organ and be oriented on what to expect during the operation. In the operation room the patient meets a nurse who will prepare the patient for the procedure and hook some machines to her body. The nurse will also ensure that the patient in the room is the right one by having her state her full names and signature and append her signature to the consent form. The patient must be in a position to state before the nurse the kind of procedure she is to undergo. After undergoing the verification process, the patient is induced with anaesthesia (Kovac & Zimmerman, 2007). She will then be observed for a period of time until the right level of anaesthesia has been reached. Incision of the skin starts at this point where the patient feels no pain as long as the correct dosage of anaesthesia has been administered. The surgical team then provides the patient with a pain control substance called analgesia, which pumps morphine into the body system. The surgeon will remove the affected abdominal organs, and the body tissues that show any defects from the abdominal surface while ensuring that he examines the spleen, liver and abdomen as well as the areas around the abdominal surface. The main purpose for the general examination of the organs around the abdomen is to ensure they are in good form to avoid further disorders. The incision will be moved back and forth from the urethra upwards for effective results (Pudner, 2005). Once the procedure is complete, the cut is dressed by the surgeon. The patient is hooked to several supporting machines such as cardiac monitor and oxygen supply machine while the procedure is underway. The abdominal parts that were removed during the procedure are critically examined by a pathologist using a microscope with the aim of identifying cancerous cells and to deduce on the degree of any cancerous material found. The pathologist’s findings will be used by the patient’s oncologist to provide the way forward. It may take several weeks before the results of the removed tissues are concluded. During this period, the patient will be put under a recovery room for close observation in case of any post-surgical complications. The patient’s health care givers, together with the doctors, will discuss the outcome of the procedure and recommend treatment immediately. At times the procedure could be the only form of treatment, but radiology and chemotherapy may be recommended depending on the kind of disease (Kovac & Zimmerman, 2007). In certain unfortunate conditions, the surgery may not lead to removal of all the cancerous cells. On rare occasions, the body organs and the cancer materials may be stuck together, making it too dangerous to remove the cancer without harming the body. Moreover, the cancer cells may be scattered over a wider area; making it practically impossible to remove all of them. Chemotherapy and radiotherapy are the most preferred options that doctors always advise to kill the remaining cancer cells. The space left after the uterus, fallopian tubes and ovaries are removed is filled by the intestines because they are always located slightly on top. Usually after the surgery, the patient is taken back to her hospital room once recovery is confirmed. The patient may stay for about five days in the hospital before she is discharged for home care. During the first weeks of the procedure, the patient is advised against tiring activities to allow a smooth healing process of the cut. A proper diet is always instructed by the nurse before leaving hospital, which includes a lot of fruits and vegetables. Constipation is almost normal after undergoing a surgical operation, requiring the patient to take plenty of high-fibre foods and a lot of water to help avert the situation (Kovac & Zimmerman, 2007). The doctor also advises on how to treat the incision area to prevent infection by making use of antiseptics and neutralizers. It is also mandatory to contact the doctor in case of any complaints while home. Complete recovery from the procedure may take a long period as it takes different dimensions. It can be emotional, sexual or physical recovery. Emotional healing for women who have undergone the procedure entails coming to terms with the fact that they can no longer bear children, staying longer in the hospital and the fear of cancer. The patient may not be used to the physical condition of her body as well as the difficulty to carry out her normal duties. Emotional recovery is a mindset; the patient should learn to believe she will come back to her normal life. The fear of catching cancer again may traumatize the patient, but with time she will come to terms with her condition (Kovac & Zimmerman, 2007). Emotional recovery may take long but is often achievable with the right support. Physical healing involves the interfered skin coming to its normal state, the muscles around the muscles gaining strength and the whole body resuming the usual energy level. This may take several weeks for the patient to get back to her routinely activities. Sexual healing includes a return to the usual way of making love and enjoying it. It might take some time for the patient to be in a position to satisfy her partner sexually since the vagina may still be painful during intercourse. The brain should also come to terms with that fact so that she can feel loved again. Some sexual positions may not be explored immediately after recovery; a longer time may be advised. Several effects associated with sex may be felt, for instance, slight reduction of orgasm. The length of the vagina decreases. Diagnosing cancer is not an easy task, making a lady feel tired, stressed or worried, hence poor sexual performance. Other effects associated with this procedure include high risk of heart diseases and breast cancer. Permanent scars, clotting disorders and risk of catching infections are other impacts. The emotional disturbances are based on the fact that some of her body parts have been extracted. Conclusion Total abdominal hysterectomy-bilateral salpingo oophrectomy is aimed at solving life threatening disease. However, the risks associated with it are many and dangerous, for example, heart diseases, infections and permanent removal of reproductive organs. Recommendations The health sector should ensure that they study new ways of removing cancer cells without permanently removing reproductive organs. Radiology may expose the patient to radiation; therefore, the cancer department should devise other ways of killing and shrinking cancer cells. References Kovac, S. & Zimmerman, C. (2007). Advances in reconstructive vaginal surgery. Philadelphia: Lippincott Williams & Wilkin. Pudner, R. (2005). Nursing the surgical patient. Edingburg: Elsevier. Scott-Conner, C. & Dawson, L. (2009). Operative anatomy. Philadelphia: Lippincott Williams & Wilkins. Read More