Endometriosis Excision Surgery: What to Expect on the Day of Surgery

Six months ago I had my endometriosis excision surgery at the Center for Endometriosis Care, and it completely changed my life! I recently shared how I prepared for surgery, which brings us right up to the day of surgery.

I thought that surgery day deserved its own post because it is a HUGE day. Personally, I was so anxious going into surgery day. Years of my life, of getting sicker and sicker, had led to this day. I felt, understandably, a lot of stress and pressure for the day to go well. The hardest thing was that, even having had another endometriosis surgery in the past, I didn’t quite know what to expect.

Everybody’s experience on surgery day will be different, but I definitely found comfort in reading about other people’s experiences. That’s why, in this post, I’ll go through a play-by-play of my surgery day, and what you can expect going into your own endometriosis excision surgery.

Waiting in my hospital bed before surgery!

What to Expect on the Day of Endometriosis Excision Surgery

First, some background information. This was my second surgery for endometriosis. You can read all about my first surgery, and how I got diagnosed with endometriosis, here.

I had my endometriosis excision surgery with Dr. Arrington of the Center for Endometriosis Care in Atlanta, Georgia. I traveled all the way from Michigan for this surgery. The surgery itself was at Northside Hospital, and most of what I share below will be specific to that experience!

Even if you are not having your surgery with the CEC or at Northside Hospital, I still think this will be useful.

7 a.m. – Wake Up Call and Final Prep

On the day of my endometriosis excision surgery, I woke up around 7 a.m. in our VRBO in Atlanta to start my final pre-surgery bowel prep. You’ll need to confirm with your surgeon the type and timing of bowel prep, because everyone’s different.

Because my surgery wasn’t until the afternoon, I could still drink clear liquids at this point. At the advice of my surgeon, I was chugging water with liquid IV electrolytes.

I already knew I’d be spending the night in the hospital, and my overnight hospital bag was all packed and ready to go. Even if you aren’t planning to stay overnight, I still recommend prepping a bag as a precaution.

Here’s what was in my overnight hospital bag:

Also, it didn’t go in my overnight bag, but I was sure to put this post-surgical seatbelt pillow and my cane in the car, prepped for my ride home from the hospital the next day.

Dan sent me this wonky little teddy bear before my endometriosis surgery, and having it with me at the hospital actually made me so happy.

8 a.m. – Pre-Op Appointment

It is kind of unusual, but I had my pre-operative appointment scheduled on the same day as my endometriosis excision surgery. This was early in the morning at the CEC’s office building, and lasted a couple hours. You can read more about it in my article on how to prepare for endometriosis surgery.

10 a.m. – Arrival at the Hospital

After my pre-op appointment, my parents (who accompanied me to Atlanta as my caregivers for surgery week) and I drove straight to Northside Hospital.

Hospital parking is always confusing, so I was really grateful we’d done a practice drive the day before. My dad dropped off my mom and I, because I was only allowed one guest in the hospital due to pandemic restrictions.

10:15 a.m. – Checking In

The very first thing I did at Northside Hospital was check in at the administration desk on the ground floor. I was taken back to a waiting room, where after 15 minutes or so I was called back to an office.

Here, they checked my identification and insurance cards, and ensured that I had paid my out of pocket maximum (which I had, on the phone during a pre-op call the week previously).

10:30 a.m. – Waiting Room

After it was decided that my identity and insurance were all above board, my mom and I were sent up a couple levels to a pre-surgery waiting room. I checked in at this desk, too, and we were given a little buzzer (like what you get at a busy restaurant when you’re waiting for a table… yup, the same exact thing. Kinda surreal!).

This was the same waiting room where my mom would sit throughout my surgery. There were a few TVs in the waiting area that had lists of patients’ names all color coded for pre-op, surgery, and post-op. My mom really liked this, because it meant she could track where I was.

We waited on the chairs in this small waiting room for only 10 minutes or so, and then a nurse called me back! She told me to come with her alone, but that once I was all set up my mom could come back and sit with me before surgery. My stomach felt like it was doing flips.

10:45 a.m. – Gowning Up

We left my mom in the waiting area, and the nurse brought me back to the pre-operative holding area, and to my own little room (with a door, not just a curtain). She left while I changed into my hospital gown and yellow hospital socks.

I was given a surprisingly nice Northside Hospital tote bag where I put my clothes and shoes that I’d worn to the hospital. I’d already taken off my jewelry at home so I wouldn’t have to worry about it getting lost in the hospital.

Then, I took the quick selfie below (lol) and got into the hospital bed to wait for the nurse to come back in.

11 a.m. – Vitals

After a brief knock on the door, the nurse came back in and helped situate me in bed. She gave me some extra blankets and this funny silver inflatable blanket thing that had hot air running through it. Not sure if these weird blankets are specific to Northside Hospital, but they are awesome. Just being warm and cozy helped my anxiety so I honestly recommend always taking them up on the extra blankets!

Next, the nurse hooked me up for vitals sign monitoring. I had a pulse oximeter taped to my fingertip, and a blood pressure cuff wrapped around my upper arm. These were connected to the electronic display screen behind me. A few times, my pulse jumped well above 100 BPM because, um, surgery day anxiety. And every time the alarm would go off and the nurses would get concerned but… it was fine in the end lol.

At this point, I also had an IV line placed and some allergy bracelets wrapped around my wrist.

With my fun silver inflatable blanket!

11:30 a.m. – Platelet Rich Plasma Blood Draw

This next part is somewhat specific to those having endometriosis surgery at the CEC. The CEC uses something called Platelet Rich Plasma (PRP) to prevent adhesions (scars) forming during surgery.

Every endometriosis surgeon will use some technique to prevent adhesion formation, but most of the time the patient isn’t aware because it happens during the actual surgery. Ah… not so with PRP!

What is PRP?

To quote from the CEC’s website:

“PRP is a product derived from the blood of the patient undergoing surgery. Plasma is the blood product that is left over after the red blood cells have been removed.  This is further concentrated to form platelet poor and platelet rich plasma.  We take the platelet rich plasma, and spray or inject it onto the raw surfaces that are present after excision of endometriosis and adhesions.” [source]

PRP has been shown to be super effective at preventing adhesions, and also reducing pain post operatively.

What is the PRP blood draw like?

The awesomeness of PRP is inherently tied to what turned out to be the worst part of my surgery day.

See, in order to create the PRP, they need your blood… a lot of your blood. I can’t remember the exact amount but I will say that the syringe was the absolute biggest syringe I’ve ever seen in my life.

I’ll spare you the gory details, but it took over half an hour, over six needle pokes, some heating packs, and two nurses to get enough blood from me. Unfortunately, somewhere in there my vein blew and I ended up with most gruesome bruise that lasted for 3 months. But… we got the blood in the end.

I don’t say any of this to scare you. My experience was kind of rogue and I’m sure yours will be better. However if, like me, you’ve had trouble with blood draws in the past, then definitely mention that and PLEASE ask them to use a small (even “butterfly”) needle. I think my blown vein was partially due to a way too large needle.

12 p.m. – Meeting the Anesthesiologist

After the PRP fiasco, my mom was allowed to come back and sit with me. Yay! We sat (well, she sat, I laid on the hospital bed) and chatted for a bit. Then the anesthesiologist came back to meet me.

Before any surgery, you usually have a discussion with the anesthesiologist about your prior surgeries and any previous reactions to anesthesia. Having had five previous surgeries, I had a lot to say to this anesthesiologist, lol.

But in all seriousness, it’s really important to mention any past bad reactions to anesthesia so that your anesthesiologist can adjust accordingly. I’ve had quite a few bad reactions, including barfing for days on end after my diagnostic laparoscopy. Trust me, you don’t realize how much ab strength vomiting requires until you do so less than 24 hours out from abdominal surgery…. would not recommend.

Anyway, the anesthesiologist seemed a little bemused by the intensity of my pleas for no nausea. I was glad I had my mom with me for this part to attest to how bad my previous surgeries were. Luckily, he did take me seriously in the end and whatever combination of drugs he used (plus to post-op zofran he prescribed) seemed to do the trick and I did not have any nausea after my endometriosis excision surgery!

12:30 p.m. – Final Talks with my Surgeon

After this, my mom and I waited around a bit again. Then, Dr. Arrington (my surgeon) came in! I’d just seen him that morning at my pre-op appointment at the CEC, so it was a bit of a “oh hello again” situation. Honestly, at that point he was also such a comforting, familiar face in the chaos of the hospital so it was really nice to see him.

I can’t remember exactly what we talked about, but I think it was mostly just catching up, and him telling my mom what she could expect during my surgery. At this point, I asked him for a photo together, and he obliged.

It might seem silly to some people, but I do really recommend getting a photo with your expert endometriosis surgeon, if you are so lucky to have one. This is a person that comes into your life for (we hope) a short period of time, but can completely change the course of your life. Although we really only had one day together, Dr. Arrington was a hero to me that I will remember for the rest of my life, and so the photo is really meaningful.

1 p.m. – The Calm Before the Storm

Then, my mom and I had a final 10-15 minutes alone together. I don’t remember what we spoke about or did… I was still feeling nervous, but also a little giddy at this point. Looking back, I think as the nerves were falling away, I was feeling excited.

Excitement seems like a strange emotion to have in a hospital, but if you also have endometriosis and excruciating chronic pain, and have worked for years to get doctors to listen to you, and you’re finally on the precipice of having an expert surgery… well, maybe that helps it make a little more sense.

1:15 p.m. – Heading to the Operating Room

Around 1:15 pm, Dr. Arrington and some nurses came back in, and said it was time to head to the OR! I hugged my mom goodbye and was given some “relaxing” medication through my IV, but did not feel the effects.

They wheeled my hospital bed out into the hallway, where I waved goodbye to my mom, and traded her hand for Dr. Arrington’s. Yep, he held my hand pretty much from this point until I went under. Like I said before, what a hero!

1:30 p.m. – Going Under

My hospital bed was wheeled into the OR and I remember it being very cold and white. I could see the da Vinci robot in the corner, and all the surgical instruments laid out. They told me I’d have to move from my hospital bed to the operating table, and I was able to do this myself without help.

Once I got on the operating table, things got a bit loopy. They had given me Versed (a sedative medicine) and I reacted preeeeetty strongly. I remember that suddenly the ceiling seemed distorted and like it was getting really close to my face and then suddenly really far away. Dr. Arrington loomed over me and asked me some questions about how I liked Atlanta, and I remember his face also looked distorted and like… a monster. Like my brain legitimately thought that my nice, heroic surgeon of 5 minutes ago was a monster.

Next, I remember them prepping the anesthesia mask and I asked “do you want me to count backward from 10?” and Dr. Arrington said “no.” They put the mask on me and I promptly began counting backward from 10, LOL. I very clearly remember that I said “10, 9, 7…” and then thought “oh shit, I missed 8,” and that was my final thought before I was knocked out!

5 p.m. – Waking Up

The next thing I knew, I was blinking my eyes open in the post-anesthesia care unit (PACU). I was awake for a few minutes before my nurse noticed. She was sitting at a computer station next to my bed and talking on the phone. I remember she said something along the lines of “yes, this one just had an appendectomy, too” and I felt this wave of relief fall over me.

I mean, on one hand it’s weird to wake up and learn so nonchalantly that you’re missing an organ you’d gone to sleep with still in your body. But what that also told me was that I had endometriosis on my appendix. So at the very least, the surgery hadn’t been pointless.

The next thing I noticed was that I really had to poop. (Sorry not sorry, clearly there is no TMI in all my endometriosis articles!). The nurse noticed I was awake, and after checking me over a bit, she gave me a bed pan.

But after a while, I couldn’t go, so she took away the bed pan. Apparently, this is a pretty common feeling when you wake up from surgery, especially if you’ve had your bowels or rectum operated on, like I later learned that I had!

I was also waiting to be overwhelmed with nausea, because this is the point when I got super nauseous after all my previous surgeries. But that didn’t happen!

My mom took this photo of me in my recovery room not long after surgery. I look so exhausted and bewildered lol!

6 p.m. – Post Op Recovery Room

After it was deemed that I was stable, I got transported to a different floor to my recovery room. This was a private room on what I’m guessing was a medical-surgical ward, and it’s where I stayed overnight.

Getting from the gurney onto the hospital bed was a minor struggle, and also when I realized how heavy and fragile my abdomen felt and that I was wearing a tight abdominal binder and giant mesh undies.

My mom was allowed in to visit me at this point, and of course my first question was if she heard what they found during surgery. Well, not only had Dr. Arrington come to see her immediately after surgery, but he had also had her take a video of him telling her about my surgery, and showing where endometriosis was excised on my new surgical photos!

I was honestly just so relieved to hear how much endometriosis was found. Even after everything with this disease, there is always a part of me that doubts myself and my pain, and this was the ultimate validation.

I look a bit more cheerful here now that I’m prepared for the photo op.

8 p.m.-10 a.m. – Staying Overnight in the Hospital

I spent the night at Northside Hospital, which I believe is pretty typical of endometriosis excision surgeries done by the CEC. Because I was in the hospital less than 24 hours, it was still considered an outpatient procedure.

The night started off relatively well; my mom had brought me some Simple Mills gluten free crackers, and I was given some super salty and delicious powdered broth. None of the other dinner options were gluten free, which is kind of wild for a hospital, but I didn’t have an appetite at all so that was fine.

I was also given some heating pads for my shoulders (for the post op gas pains, which was the first pain to start up, and can be pretty intense). I’d brought my own GasX and the nurses approved me to take it alongside the other medications I was on.

The night itself was rough. I slept in about one hour maximum increments. As it came time for my next dose of pain meds, I would be unable to sleep. But the nurses were so busy that they were often 1 hour or even 2 hours late with my next dose. I tried not to press the call bell too often because I thought, they’re probably dealing with so much worse and we all know how short staffed hospitals are. However if I had to do it all over again I probably would’ve just pressed the damn call bell.

I also needed to press the call bell any time I got up to go to the bathroom. Walking was a challenge physically, but also involved pushing my giant IV and fluids pole and getting unhooked from my blood pressure cuff and the intermittent pneumatic compression devices on my legs. It was a WHOLE ordeal.

Probably the best thing I brought to the hospital was this blackout eye mask. Honestly, it costs less than $10 and is the only reason I slept a wink that night.

Post endo surgery hospital must haves!!!
I needed to take a selfie the following morning to commemorate my love for this eye mask.

Endometriosis Excision Surgery Recovery

I’m going to save my endometriosis surgery recovery story for another blog post. Because now over six months out, I will say that is a whole other topic that deserves way more detail.

I do hope that this has been helpful for anyone going into their endometriosis excision surgery, whether at Northside Hospital or elsewhere! Your experience will undoubtedly be different from mine. But I hope that reading about my surgery day gave you some comfort, and some ideas of what to expect!

If you have any questions about endometriosis excision surgery, with the CEC or elsewhere, feel free to leave a comment below.

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