Is an ovarian cyst laparoscopy safe in pulmonary dilation?

Hi,

Welcome to icliniq.com.

I can understand your concern. According to your statement, your partner has been suffering from ovarian cyst pain for the last two to three weeks. Laparoscopic surgery of ovarian cyst was postponed due to her pulmonologist's findings of mild dilatation of the pulmonary cone on her HRCT of chest, according to your description. She was COVID-19 positive.

According to her, HRCT (high-resolution computed tomography) of the chest has revealed that baseline fibroatelectatic changes are bilateral. And a small pneumatocele in the right segments 6 and 8.

Well, atelectatic changes bilaterally have been found on her HRCT of the chest. Atelectasis is a complete or partial collapse of the area or lobe of the lung. It occurs when the tiny air sacs or alveoli within the lung become deflated or possibly filled with alveolar fluid.

Risk factors for atelectasis are anesthesia during the operation, mucus that plugs the airway, underlying lung diseases, and others. Atelectasis can be aggravated, which is the most common life-threatening breathing or respiratory complication after surgery.

Atelectasis is sometimes asymptomatic and shows no clinical features like cough, breathing difficulties, etc. It usually gets better with time or treatment. But if it is undiagnosed or untreated, and then serious complications may occur, like pneumonia, respiratory failure, and so on.

Again, a pneumatocele has been found in her lung. They are thin-walled, air-filled cysts or emphysematous lesions that develop on the lung. They may have resulted as a consequence of pneumonia, hematoma, lung injury, pulmonary trauma, or COPD (chronic obstructive lung disease).

According to your partner's HRCT of the chest, it is obvious that she needs treatment for her lung findings as well as rest. Any type of surgery may aggravate her asymptomatic atelectasis and pneumatocele and cause severe respiratory distress, respiratory failure.

For that reason, her pulmonologist has advised her not to undergo surgery.

I hope this helps.

Thank you.

Hi,

Welcome back to icliniq.com.

Yes, her lung condition is treatable. Treating atelectasis depends on the underlying cause and how severe her symptoms are. If she has been suffering from a cough, she can take bronchodilators like Salbutamol with or without antibiotics like Azithromycin. Otherwise, no treatment is needed without chest physiotherapy or breathing exercises.

Breathing exercise may be performed using an incentive spirometer that forces her to breathe in deeply and help open up the alveoli, or blow the balloons with air. She can consult with a chest physiotherapist for physiotherapy that will help loosen and drain mucus. It is difficult to predict the duration of time when she will be fit for surgery.

It may take a few days to months, depending on the causes. An MRI (magnetic resonance imaging) chest or a bronchoscopy can be done to exclude the causes.

General anesthesia is a common cause of atelectasis. Nearly everyone who has major surgery develops some amount of atelectasis. If your partner is scheduled for surgery, talk to her doctor about strategies to reduce her risks. Certain breathing exercises and muscle training may lower the risk of atelectasis after surgery.

During induction of anesthesia, the application of PEEP of 6 cm H2O can prevent atelectasis and increase the margin of safety before intubation.

Again, epidural anesthesia causes no or little atelectasis and no change in shunting, ventilation/ perfusion ratio. As your partner has not presented signs and symptoms of atelectasis, discuss with her surgeon and anesthesiologist, along with her HRCT of the chest report. They will find a way to operate on her ovarian cyst.

They can also advise doing some more investigations, like pulmonary function test, ABG (arterial blood gas) analysis, oxygen saturation rate by a pulse oximeter, MRI chest, or bronchoscopy, etc. After examining the reports of these investigations, they will fix the probable date for the operation.

I hope this helps.

Thank you.

Hi,

Welcome back to icliniq.com.

Yes, ovarian cyst and umbilical hernia can be operated on in the same operation. I have already mentioned that some investigations will be needed for assessing her present lung status, like pulmonary function test, ABG analysis, oxygen saturation rate, MRI of the Chest, or Bronchoscopy.

After assessing her current lung status, it can be finalized the possibility of operation. It will take two hours, and that is normal for two operations. Well, the decision of operation will depend on both the surgeon and the anesthesiologist, as I have mentioned earlier that u can consult with the surgeon and anesthesiologist with her radiological reports.

According to ur description, she has no symptoms of cough, shortness of breath, etc. Surgery may aggravate her atelectasis, which is the only problem.

Bronchodilators like Salbutamol, oral or injectable steroids may be used before her surgery if her pulmonologist or anesthesiologist wants, and after surgery, those medications, if needed, or breathing exercises can help her recovery.

Epidural anesthesia can be used during anesthesia if there is no contraindication. After assessing ur girlfriend, her pulmonologist advised what medications or measures should be taken to undergo an operation? It is his duty to advise or prescribe for his patients for their future betterment.

Since I have not examined your partner personally, my opinion may not be fully accepted. Still, I genuinely want to help you. If you have any other questions, feel free to ask.

I hope you find this helpful.

Thank you.

Hello,

Welcome back to icliniq.com.

If your girlfriend has no symptoms at present, then how can her lung condition become critical at present? Her atelectasis was found accidentally on her radiological test. The ovarian cyst becomes larger and may rupture. A ruptured cyst can cause heavy bleeding or Infections that may become a life-threatening condition.

Then who will be responsible? Please, provide me with the email address of her pulmonologist. I will send her the pulmonologist's email regarding my opinion and ur patient's present sufferings.

hi, thank u for joining again. honestly I am waiting for your reply. waiting for the pulmonologist's Email address.because I have to keep my words. thank you so much to the almighty that the operation will be held on soon. thank you both u and ur girlfriend, because both of u r highly educated. both of u was able to understand my medical explanation as well as even convince the pulmonologist and the surgeon. hats off both of u for ur wisdoms and knowledge.it is almost impossible to convince a doctor to change his or her treatment plan. but both of u did it possible. I did nothing, just sharing my few knowledges with u. nothing else. Happy new year both of u,too.keep continuing ur love story. ok, let's go to the matter. well, she mayn't need to do any breathing exercise after surgery. but for her safety, as a precaution, she can try to do practice some breathing exercises.breathing exercise may be performed by using an incentive spirometer that force her to breathe in deeply and help to open up the alveoli. even she can practice to blow few balloons every day. such type of breathing exercises may help to expand her chest and improve her lung capacity as well as prevent the lungs from collapse or developing atelectasis. she can blow few balloons every day and I think that is enough for her. take care.happy new year,both of u again.let me know if I can assist you further.