Operation Checklist

Two Weeks Prior to Surgery:

Most Aspirin type tablets and arthritis medications should be stopped well in advance of major surgery.  It is important that you discuss this with me prior to your operation. Herbal or Naturopath Preparations often have anti-platelet (aspirin-like) actions and can cause severe bleeding. This includes fish oil, krill oil and Evening Primrose Oil, so stop these as well. 

Seven Days Prior:

Ensure a good bowel habit prior to undergoing surgery.  Many medications can exacerbate or cause constipation.  In this regard prevention is better than cure.  Some patients, undergoing more extensive surgery, will be provided with a preoperative bowel preparation kit (Pico-Prep) but for those patients having minor procedures, there are some simple medications which can help prevent postoperative constipation. The following have been helpful for my patients in the week prior to surgery.   

• Metamucil  

• Coloxyl  

• Movicol 

• Epsom Salts  

Use as per the directions on the pack, bearing in mind that a daily dose of any ONE of these will be all that most people will require.  For those patients with more significant pre-existing bowel problems it is better to ask for specific advice.

One Day Prior:

For those having a major abdominal procedure or complicated laparoscopic operation, this is when the Pico Prep (bowel prep) is used.  My patients have their surgery in the morning (8 a.m.-12 md.). 

It is important not to eat or drink for 6-8 hours prior to your scheduled operation.  At the same time, it is important not to become dehydrated prior to your surgery and a few sips of water are allowed, especially if you need to take a medication (blood pressure tablet) in the morning.  

If you are taking a regular medication, it is important that you mention this prior to surgery so that you can be advised which medications should be stopped or continued prior to your operation. 

On the Day of Surgery:

On arrival at the hospital there is always some paperwork to be completed at the front reception desk.  You will then be taken to either a Day Surgery Area (for relatively minor procedures) or to a Surgical Ward and a nurse will admit you to the hospital.  It is a normal process for multiple people to ask you the same questions regarding allergies, medications and the type of surgery you are to undergo.  It can be enormously helpful if you have this information written down prior to arrival at the hospital. 

In Theatre:

It's a bit cold and noisier than you might think. The Anaesthetist will chat, even to you, put in a drip, give you the sleepy drugs and then wake you up when it’s all over. 

Immediately post operatively:

Cold - Operating theatres are cool (temperature wise). So, during a long operation, despite best efforts you may become cool yourself. Some shivering is relatively normal as you wake from the anaesthetic. Shivering is also a common response to Spinal or Epidural anaesthesia.  

Pain - Most patients will wake from their general anaesthetic and experience some pain. This will vary depending on the type of procedure, how it was performed, how much pain relief was given during the operation and on the individual. The nurse in the recovery area will ask you to grade your pain from 1 (mild) to 10 (severe) so that the appropriate amount of pain relief can be given. They will get on top of your pain quickly but it will always feel much longer than it was. 

Information - You may want to know all the details of your surgery straight away, but this is not always helpful. General anaesthetics often cause you to forget everything you hear in the first hour after surgery. Sometimes you may only remember parts of the conversation or remember part of what was said by a nurse nearby. This snippet of conversation may not even be related to your operation. I was once chastised by a patient for not talking to them immediately after the operation. But, I had spoken to the patient twice! Once, in recovery, immediately after surgery and again 30min later! It took 3 nurses to convince the patient of this.  

One - Four Hours Post-Operation:

For those undergoing a relatively minor procedure such as a Curette (D&C Hysteroscopy), discharge from hospital is usually about 4 hours later. You should always have the opportunity to speak to me directly at some point prior to discharge, either in person or by phone, if I am elsewhere. For those having more major surgery, you will be reviewed that afternoon but I will not wake you to say ‘Hi' if you are asleep. Sleep is good for recovery and most patients learn more about their operation the next morning on my routine rounds. It is much easier to focus on and appreciate any photographs I have taken during the operation. It is also likely that your pain medication will put you to sleep or alter your memory of any conversation we have in this initial post-op phase. 

Other Post-Operation Information:

Day Surgery:  

A short note about this:  Day Surgery just means you go home that day. It does not mean you won't be sore and it doesn't mean you can immediately return to normal activity (adult or otherwise).     

Anaesthetic Side Effects: 

Nausea:  Nausea is difficult to treat and can be quite debilitating in a minority of patients.     

Next Day:  This is where different operations and methods of doing procedures will make a larger difference. Go here for an outline of different procedures and the common course of recover, +/- a few more common variations.  Deep Vein Thrombosis (DVT) is a potential complication of major surgery and many patients will be given injections each day after surgery to reduce this risk.     

Follow-up:  All patients will be told what follow-up is required. Sometimes this is just ‘see your GP for a pap smear in 2 years'. Others it will be review in 7-10 days or 4-6 weeks. It varies with the procedure and any tests which have been done.