Perioperative management - Bilateral adnexectomy, lavage cytology, laparoscopy

Conducting an adequate medical history and a gynecological examination. The examination serves to identify other pathologies of the uterus or adnexa, potentially avoiding surgery. Additionally, determining the actual distress or needs of the patient. Subsequently, informing about alternative treatment options.

Blood works (depending on the needs of the clinic)

Further examinations (MRI, CT) are only useful with corresponding indications.

• Wound healing disorder
• Infection, rarely intra-abdominal abscess requiring revision or percutaneous drainage
• Postoperative ileus
• Adhesions
• Injuries to other organs, intestines, bladder, ureters
• Subcutaneous emphysema
• Post-laparoscopic shoulder pain syndrome
• General surgical risks (bleeding, rebleeding, thrombosis, embolism, HIT)
• Possible conversion to open technique in case of complications
• Urinary retention
• Positioning injuries
• Burns
• Dissemination of benign as well as malignant cells, in rare cases of malignancy, worsening prognosis
• Information about alternative treatment methods
• Premature menopause

• no preoperative bowel evacuation
• no shaving
• if necessary, antibiotic prophylaxis during induction of anesthesia (cephalosporins group 2 and metronidazole), depending on the extent of the operation

• Remove catheters, drains, and tampons as early as possible
• Thrombosis prophylaxis for 7 days, adjust if necessary in case of prolonged immobilization or infection. Extend to 4 weeks for oncological procedures.
• No restriction on food intake

A final examination should be conducted before discharge.

• Physical examination with palpation of the abdomen,
• if necessary, a speculum setting with rectal/vaginal examination should also be performed.
• if applicable, renal sonography
• Information about postoperative behavioral measures (resumption of moderate to heavy activities in 2-3 weeks)