Laparoscopic oophorectomy is a minimally invasive surgical procedure for removing one or both ovaries. This technique uses small incisions and specialized instruments, contrasting with traditional open procedures. This article addresses the typical duration of the operative phase, the factors that influence this timeline, and what to expect immediately following the procedure.
What is Laparoscopic Oophorectomy?
Oophorectomy is the surgical removal of an ovary. The laparoscopic approach uses small abdominal incisions and is generally preferred for its reduced recovery time and smaller scars compared to a large abdominal incision. The procedure is indicated for various conditions, such as persistent ovarian cysts, ovarian torsion, endometriosis, or as a risk-reduction measure for certain cancers.
The surgeon inserts a laparoscope, equipped with a camera and light, through a small cut near the belly button. Carbon dioxide gas is used to inflate the abdominal cavity (insufflation), which creates space and improves the surgeon’s view. Additional small cuts are made to insert ports for surgical instruments used to detach the ovary from its blood supply and surrounding tissue.
Removing one ovary is a unilateral oophorectomy; removing both is a bilateral oophorectomy. The fallopian tube is often removed alongside the ovary. The detached tissue is placed into a surgical bag and removed through an incision site. The procedure concludes when the carbon dioxide gas is released and the incisions are closed.
The Surgical Timeline: Duration and Variability
The actual surgical time, measured from the first incision to the final stitch, is typically between 60 and 120 minutes. This estimate covers the full operating room duration, including patient positioning, establishing the ports, the main dissection and removal of the ovary, and the final suturing of the incision sites.
The most significant factor influencing the total time is whether the procedure is unilateral or bilateral, as removing both ovaries takes longer. The presence of dense scar tissue, known as adhesions, from prior surgeries or conditions like endometriosis can also substantially lengthen the procedure.
Adhesions obscure the surgical field and require careful, time-consuming dissection to safely separate the ovary from adjacent structures like the bowel or bladder. Furthermore, the size and complexity of the mass being removed play a role. A large cyst or a suspected malignant mass requires more careful isolation and removal, which can extend the operating room duration. The experience level of the surgical team also contributes to the procedure’s speed.
Immediate Post-Procedure Expectations
After the surgical wounds are dressed, the patient transitions to the Post-Anesthesia Care Unit (PACU), or recovery room. This stage is dedicated to monitoring the patient as they fully wake up from general anesthesia. Nurses closely monitor vital signs, including heart rate, blood pressure, and oxygen saturation, ensuring they remain stable.
Patients typically spend between one and three hours in the PACU, although this duration can vary based on individual response to anesthesia and initial pain levels. Shoulder pain is a common symptom, which is referred pain caused by residual carbon dioxide gas irritating the diaphragm. Managing pain and nausea is a priority during this time, and medication is administered as needed for comfort.
Laparoscopic oophorectomy is usually an outpatient procedure, meaning same-day discharge is common. Before going home, the patient must meet specific criteria:
- Being fully awake.
- Able to tolerate liquids.
- Having pain well-controlled with oral medication.
- Able to walk with assistance.
The total time spent at the facility, from arrival to discharge, is typically around four to six hours.