Concerns About Laparoscopic Surgery: Seeking Expert Advice on Post-Op Issues

I have questions regarding laparoscopic surgery. Please help me, thank you!

Hello Dr.
Huang,
My sister is 23 years old.
Last summer, she underwent laparoscopic surgery for an ectopic pregnancy at Hospital A in Taichung, where three incisions were made.
After the surgery, everything returned to normal.
In December of the same year, she became pregnant and had a cesarean section at another hospital, Hospital B, in August of this year.
Just yesterday, while taking a shower, she discovered cotton in her navel.
She pulled it out and found a hole; the more she pulled, the more it hurt.
With only a little cotton left, she was afraid to pull it out further, so she went to see a doctor at Hospital A.
However, the doctor claimed there was no cotton, only dirt, and that there was inflammation.
Clearly, there was cotton! Is the doctor trying to evade responsibility? The doctor advised my sister to go back to Hospital B and ask the doctors there if they had affected her navel during the cesarean section.

Dr.
Huang, based on your expertise, could you please tell me if a cesarean section could potentially affect the navel? Who is responsible for this situation, Hospital A or Hospital B? How can they evade responsibility? This is a serious breach of professional ethics.
Please help my sister.
If the material in her navel is not cleaned out properly, what could happen? The doctor mentioned that there is already inflammation and that it almost affected the abdominal cavity.
What should we do now?
We trust your expertise, which is why we are reaching out to you for help.
Thank you very much in advance, Dr.
Huang!
Could you please respond as soon as possible? Thank you!
Cherry 2003/12/30

cherry, 20~29 year old female. Ask Date: 2003/12/30

Dr. Huang Jianxun reply Obstetrics and Gynecology

It is indeed difficult to make a judgment.
The law is based on evidence as its foundation.
If you can provide strong evidence beyond just written statements, it may be more beneficial for you.
Otherwise, each side will have its own reasoning.

Reply Date: 2003/12/30

More Info

Dear Cherry,
Thank you for reaching out with your concerns regarding your sister's post-operative situation. I understand how distressing this must be for both of you, and I will do my best to provide clarity on the matter.

Firstly, regarding the issue of the cotton found in your sister's navel after her laparoscopic surgery for ectopic pregnancy and subsequent cesarean section, it is essential to understand a few key points about surgical procedures and post-operative care. Laparoscopic surgery typically involves making small incisions in the abdomen, and in your sister's case, three incisions were made. The navel is not typically involved in laparoscopic procedures unless specifically required for access, which is uncommon for ectopic pregnancies.
However, during a cesarean section, the surgeon usually makes an incision in the lower abdomen, and the navel is generally not directly affected. That said, it is possible for surgical materials, such as gauze or cotton, to inadvertently be left behind during any surgical procedure, though this is a rare occurrence due to strict protocols in surgical settings. If your sister indeed found cotton in her navel, it raises concerns about the thoroughness of the post-operative care and the responsibility of the surgical team.

As for the inflammation noted by the doctor, it is crucial to address this promptly. If there is indeed an infection or inflammation present, it could lead to more severe complications, including the risk of abscess formation or even peritonitis if the infection spreads to the abdominal cavity. The presence of foreign material, such as cotton, can exacerbate these issues, as it may serve as a nidus for infection.

In terms of responsibility, it can be challenging to assign blame without a thorough investigation. Both hospitals have roles in your sister's care, and it is essential to communicate openly with both surgical teams. If the cotton was indeed left behind from the laparoscopic procedure, the first hospital may bear some responsibility. However, if the cotton was introduced during the cesarean section, the second hospital would need to address this.

Given the current situation, I strongly recommend that your sister seek a second opinion from a qualified surgeon or a specialist in obstetrics and gynecology. They can perform a thorough examination, possibly including imaging studies, to assess the situation accurately. If there is any indication of infection or retained foreign material, appropriate interventions, such as antibiotics or surgical removal, may be necessary.

In conclusion, while it is understandable to feel frustrated and concerned about the perceived lack of accountability from the medical teams involved, it is crucial to focus on your sister's health and well-being. Prompt medical evaluation and intervention are vital to prevent any potential complications. Please encourage your sister to seek immediate medical attention to address her concerns and ensure her recovery is on the right track.

Thank you for trusting me with your sister's case. I hope this information helps guide you in the right direction. Please feel free to reach out if you have any further questions or need additional assistance.

Best regards,
Doctor Q&A Teams

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