Supplements of anti-oxidants as vitamin C might be useful to deal with oxidative stress. If not useful they do not harm.
During Surgery : updated microsurgical principlesTechnique of surgery
Reduce duration of surgery but remain safe
Gentle tissue handling : reduce as much as reasonable grasping, pulling and pushing, with as little force as possible. A minimal trauma damages mesothelial cell integrity.
Moisten gauzes or packs when used.
Prevent bleeding and prevent fibrin deposition by lavage.
Reduce de-vascularized or ischaemic tissue as much as practically possible. Thus avoid excessive coagulation and unnecessarily deep and tight suturing.
During laparoscopy with CO2 pneumoperitoneum
Add 10% of N2O
Cool the cavity to some 30 °
At the end of surgeryExtensive lavage until the liquid is clear. This can require up to 8L and should comprise also the upper abdomen.
Dexamethasone 5 mg IM
Apply a barrier to keep opposing lesions separated
Ovariopexie to keep the ovaries out of the pelvis might is useful but this is unclear. If performed it is unclear for how long.
After surgeryDo not delay unnecessarily long drinking and re-alimentation in order to resume bowel movements as early as possible.
Start prophylactic antibiotics when the risk of infection is increased such as after opening the vagina or the bowel
Content approved and/or updated byPhilippe R. Koninckx , Prof em OBGYN KULeuven Belgium, Univ of Oxford-Hon Consultant, UK, Univ Cattolica, Roma, Moscow State Univ. ; Gruppo Italo Belga, Villa del Rosario Rome Italy ; Anastasia Ussia Gruppo Italo Belga, Villa del Rosario Rome Italy, Consultant Università Cattolica, Rome, Italy,
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