Pelvic Abscess Laparoscopyin Bhavnagar: Procedure, Benefits & More

It is not uncommon to find an abscess, usually appearing on your skin superficially or present internally within your body, which are pus-filled sacs caused due to infections. There are different abscesses depending on the location or area where they develop. This article will discuss pelvic abscess, a pus-filled pocket found in the pelvic region. 

It commonly occurs within the female pelvis, with men rarely affected by it. A pelvic abscess is generally treated with antibiotics and surgical drainage through an open approach (laparotomy) or laparoscopy (minimally invasive procedure). Read on to know more about pelvic abscess laparoscopy, how it is performed, and its benefits and potential risks.

A pocket of inflammatory fluid (pus) within the pelvic region is known as a pelvic abscess. Pus is a yellowish-white fluid consisting of white blood cells (WBCs), microorganisms, and dead tissue. Any infection in your body can cause an inflammatory response, leading to pus forming within a confined area. 

A pelvic abscess may typically occur in females in the pouch of Douglas, fallopian tube, and ovaries, following lower abdominal surgeries. Apart from infections, a pelvic abscess can also occur as a complication of previous abdominal or gynecological surgeries, appendicitis (inflammation of the appendix), trauma, pelvic cancers, or Crohn’s disease (a type of inflammatory disease of your digestive system). 

A small pelvic abscess may be asymptomatic and often go unnoticed; however, larger abscesses cause severe abdominal and pelvic pain with discomfort. Other symptoms include:

• A high-grade fever (> 104?)
• Abdominal bloating, nausea, and vomiting
• Loss of appetite with significant weight loss
• Loose Stools (Diarrhea)

Management of a pelvic abscess depends on the size and severity of the abscess.

• Small abscesses are managed by medical treatment. Blood culture is done, and the organism causing the abscess (infection) is identified. Your doctor will prescribe the antibiotic against that organism to eradicate it.
• Larger abscesses are treated through surgical drainage in combination with antibiotic therapy. Surgical drainage is either through laparotomy (open approach), laparoscopy (minimally invasive approach), percutaneous drainage (Ultrasound or CT guided drainage), or endoscopic drainage (using a special instrument known as an endoscope).

Several minimally invasive procedures have been introduced that are gaining momentum since they involve minimal trauma to the surrounding structures, bleeding, and scarring with quick healing and shorter recovery time. Laparoscopy is a revolutionary surgical approach that uses a special medical instrument known as a “Laparoscope”, a long thin tube with a light source and a tiny camera at one end of the tube. Your surgeon gains access to the surgical site through images captured by this instrument, inserted through keyhole-sized incisions (cuts), and projected on a large screen. A laparoscopic pelvic abscess is a minimally invasive surgery for draining the pelvic abscess.

Before any surgical procedure, you must follow certain guidelines for a successful surgery with good post-op recovery. 

• You must discuss your expectations from the surgery with your surgeon to understand the planned procedure.
• Your doctor will advise some tests before the procedure:
  • Blood analysis: To determine the presence of any infection.
  • Blood culture: To identify the organism causing the infection.
  • X-ray: To check for any abnormality in your lungs.
  • Ultrasound and CT (Computed Tomography) scan: To check for the size and extent of the abscess and the presence of an abscess rupture.
• You must inform your surgeon if you have a history of diabetes, hypertension, drug allergies, etc.
• You may be advised to stop medications like blood thinners (that may cause bleeding) or other herbal medications.
• You will be asked to eat a healthy and well-balanced diet to prepare your body to cope with the surgery.
• If you are a smoker and an alcoholic, this may interfere with wound healing and cause complications like infections; hence you may be advised to quit smoking and alcohol at least 1 to 2 weeks before the procedure.
• If your anesthesiologist has advised you to get the procedure done under general anesthesia, you must fast 6 to 8 hours before the surgery.

A pelvic abscess laparoscopy is an outpatient or a daycare procedure wherein you can go home the same day. The procedure usually takes 60 minutes to 90 minutes. 

• Once you reach the hospital, your nurse will check your vitals (blood pressure, sugar levels, pulse, heart rate, and oxygen level), and you will be wheeled into the operating theatre.
• It is performed under general anesthesia so you will be unconscious during the surgery.
• Once the effect of anesthesia sets in, your surgeon will make multiple, keyhole-sized incisions using a surgical instrument (scalpel), around your abdomen area. 
• A tube is inserted through one of the incisions to pump gas to inflate your abdomen, allowing the surgeon to see the organs clearly.
• A laparoscope will be inserted through this tube, and a surgical instrument from another incision to puncture the abscess. 
• A catheter (thin draining tube) will be inserted through another keyhole-sized incision, secured with surgical tapes, and kept for 2 to 3 days.
• The incisions will be closed with stitches that usually dissolve on their own (resorbable stitches).
• A waterproof surgical dressing will be placed over it to prevent post-op infections.

Post-surgery observation in a recovery room is important to monitor your vitals like BP (blood pressure), respiratory rate, urine output, sugar level, pulse rate, and heart rate will be monitored. You can expect the following after a pelvic abscess laparoscopy:

 On the day of surgery

• Once you regain consciousness, you will be shifted to your room. 
• When the effect of anesthesia wears off, you will likely experience mild pain, bruising, and discomfort that usually resolves within 2 to 3 days.
• You will be given sips of water 4 to 5 hours after the effect of anesthesia wears off and gradually progress to a bland liquid diet.
• Once your surgeon gives you a green signal, you will be ready to go home. Sometimes, you may need to stay in the hospital for 1 to 2 days.

1-day post-surgery

• You will be advised to stay active to prevent the formation of blood clots. Walking is a good activity to improve blood circulation.
• Proper rest and sleep are important for optimal healing and quick recovery.
• You can shower but remember to avoid soaking your surgical dressing to prevent wound infection. You will need to change the dressing every 2 to 3 days.

1-week post-surgery 

• The drainage tube (catheter) will be removed after a week.
• You can resume your routine activities but must refrain from lifting heavy objects and strenuous activities for 2 weeks. 
• You should avoid smoking and alcohol for at least 2 to 3 weeks since it may delay wound healing.

Recovery usually takes 3 to 4 weeks for a pelvic abscess laparoscopy.

Pelvic abscess laparoscopy is a common and safe procedure for surgical drainage of the abscess with the following benefits and risks involved:

Benefits: 

• Minimal scarring due to small incisions.
• Provides faster wound healing with a shorter recovery time.
• Provides a permanent solution to eliminate pain and discomfort.
• It not only drains the pelvic abscess but also helps to repair any damage occurred to the surrounding structures and organs.

Risks: 

• Wound infection with fever, chills, and body aches. 
• Allergic reactions due to anesthesia that causes hives, rash, nausea, dizziness, confusion, and shortness of breath.
• Recurrence of the abscess.
• Numbness around the abdominal or pelvic area due to nerve damage.

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin!