The operation you are having is called a modified radical hysterectomy, bilateral salpingo oophorectomy and lymphadenectomy, this means the uterus, tubes, ovaries and the lymph nodes in your pelvis will be removed. A biopsy of some fatty tissue that hangs from the bowel called the omentum may also be performed.
Your admission to hospital
You are required to check in at the Admissions Desk of the hospital on arrival. You will then be admitted to the ward.
Please bring to hospital with you any medications you might be taking and any x-rays. The nursing staff will attend to your admission. This involves asking a series of questions (if you have not attended the nursing pre-admission clinic prior to your procedure). Your blood pressure, temperature, pulse and weight will be taken.
An anaesthetist will see you to discuss your anaesthetic and post-operative pain management just before your procedure.
To help reduce the risk of clots in your legs you will be given support stockings to wear. You will also be given Clexane injections and wear calf compression devices to assist with this.
An enema will be given to you on the night before your operation to help empty your bowels.
A shave of your abdomen and pubic area will be attended
You may be given a premedication injection to help you relax
A nurse from your ward will escort you to theatre
An intravenous drip and possible an epidural will be inserted
Your surgery will take approximately 2 hours
You will wake up in the recovery room and stay for up to 2 hours, depending on your blood pressure and pain relief requirements
After your Operation
On return to the ward the nurses will monitor you closely
You will have an intravenous drip in your arm and an infusion for pain relief
A fine catheter will be in place, draining urine from your bladder for 2 days
The incision in your abdomen may be vertical (up and down). There will be no visible stitches
You will be allowed to have fluids the day after your operation
You will be assisted to mobilise (sitting out of bed by Day 2 and showering by Day 3)
The physiotherapist may show you how to do breathing and leg exercises
You will continue to wear the support stockings for the duration of your hospital stay and 2-3 weeks following discharge.
Some vaginal bleeding following surgery is expected and will be monitored
Your Discharge from hospital
The usual length of stay is 4 days
Prior to your discharge you will be given information about what to do during your recovery
A post-operative appointment will be made for you in 6 weeks
At your appointment the doctor will explain the results of your surgery again and any further treatment you may require
Follow up at regular intervals will continue
Possible Complications of Surgery
The operation may involve removing tissue from the walls of the major veins and arteries. The average blood loss is 200 ml and rarely patients will require a blood transfusion.
A minor infection of the wound or the bladder occurs in up to 10% of patients. Severe infections are rare.
Damage to Surrounding Organs
It is possible that the bladder, ureter or bowel may be damaged during the operation. These injuries are rare.
Blood clots may develop in the veins of the legs or pelvis. A clot can occasionally travel to the lungs causing breathing difficulties and in extreme cases even death. A number of precautions including support stockings, anticoagulant injections, calf compressors, leg exercises and early mobilisation are taken to decrease the risk of clot formation.
There is approximately a 1 in 100000 chance of dying from anaesthesia. However a number of minor complications can occur (eg. broken teeth, sore throat). Discuss any concerns with the anaesthetist before the operation.
Any surgery causes a degree of discomfort. Post operative pain relief is a priority for our patients and options for analgesia will be discussed with you.
The above list covers the main possible side effects and complications of your surgery but is by no means complete. Please discuss with your doctor any specific concerns you may have about the proposed procedure. This list of complications appears daunting but the overall risk of a major complication is low.
Results of Treatment
Endometrial cancer is a cancer of the womb. This type of cancer has a relatively good outlook with between 75-90% of patients being cured.
Your surgery can have a number of outcomes –
- The cancer has been completely removed and no further treatment is required. Your chance of the cancer returning is less than 10%
- The cancer could not be completely removed and/or it is present in tissues outside the womb. You will be offered further treatment, usually in the form of radiation therapy. In some cases hormone therapy or chemotherapy are options. In this case complete cure is possible, but less likely.