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Knowing what to expect before, during, and after surgery can help ease your fears. Knowledge can also help you take an active role in your recovery.
Being an active patient means asking questions and not agreeing to anything until you understand it and believe that it's for the best. Taking an active role also includes finding out about the cost of your treatment.
Minor surgeries that can be done in your doctor's office
or at a same-day surgery center usually take less than 2 hours, and you can
recover at home after the surgery. For these, you most likely will need only
oral pain medicines after your procedure. Examples of these types of surgeries
For more major surgery or emergency surgery, you will
probably stay in the hospital.
Health Tools help you make wise health decisions or take action to improve your health.
You will have an
appointment with your surgeon before your surgery. For this appointment, take
surgery question form(What is a PDF document?) to help you understand your treatment.
will explain why your surgery is needed, what it will involve, what its risks
and expected outcome are, and how long it will take you to recover. Talk to
your surgeon about any concerns you have about the surgery. You may also want
to ask about treatments you might try other than surgery.
Most surgery centers and
hospitals have a before-surgery form for you to fill out. This form usually includes
questions about your medical history and current health.
information helps the surgical team prepare for your surgery. They are trained
to provide you with safe care during your surgery. You most likely will complete the
form 1 to 3 days before your surgery.
Talk to your surgeon about what kinds of
surgery you have had in the past. Describe your recovery period, and be sure to mention any
problems you may have had.
Describe any health problems you have,
It's important to
tell your doctor about any tobacco, alcohol,
illegal drugs, or medicines you use. This includes over-the-counter medicines, vitamins, and supplements, such as
St. John's wort and diet aids. Your use of substances or medicines may affect your reaction
anesthesia or pain medicines.
any physical restrictions you have, such as an artificial joint or limited
range of motion of your neck, arms, or
Let your doctor know if you have any metal implants or
fragments in your body.
Tell your surgeon if you
are or might be pregnant.
Before surgery, your surgeon may also ask you to see your regular doctor for an exam and possibly for tests. A surgeon may ask this to make sure that surgery is not likely to be too hard on you. The tests may include:
You may also be scheduled for other tests, such
X-rays or an
electrocardiogram (EKG), if your surgeon thinks they
are needed before your surgery.
Your surgeon may include other
doctors in your care, depending on your other medical conditions. For example,
if you have heart problems, your surgeon may discuss your care with a
If you have many medical problems, your
regular doctor may do your physical exam before surgery. To help make sure that
no problems are missed, you may find it helpful to have a doctor who knows you well
do this exam and your medical history.
If you will need blood
during your surgery, you may wish to donate your own blood. This has to be done several weeks before your
Many hospitals or surgery centers have a nurse who will
meet with you or call you at home a few days before your surgery. This nurse
makes sure all your forms and tests are complete before your scheduled surgery.
The nurse also:
Before your surgery, your surgeon
or nurse will remind you to do the following:
When you arrive for
your surgery, your nurse will:
Your nurse will also explain to you what will happen and will reassure you to help you
stay calm. He or she may go over a
pain scale, which may be used to help see how you are doing
Your surgeon or the surgical team may also give you
some information on what will happen after surgery, such as whether you will
have special equipment, like another IV, a urinary catheter, or wound
The nurse will have you:
The nurse will give you any medicines ordered by your surgery team, such as:
The nurse will tell your family or friends how long you
will be in surgery and in the recovery area. The nurse will also let them know where they can wait during your
The nurse will answer any questions you or your family members
have about your surgery. Tell the nurse who you want to be contacted right after
your surgery to talk about how the surgery went.
A special surgical team helps the surgeon
with your surgery. This team usually includes:
In university or teaching hospitals, doctors with different
levels of surgical training may watch or help with your surgery. But your
surgeon will be in charge.
The surgical team is trained to provide
you with safe care during your surgery. Before they start, the team members will double-check your name, what type of surgery you are there for, and what part of your body is to be operated on.
If you are having
general anesthesia, a breathing tube (endotracheal tube) is placed in your windpipe or a
special airway (laryngeal mask airway, or LMA) is placed in the back of your
throat to help you breathe during the surgery. For more information, see the
The place on your skin where the
incision will be is washed with a special solution to remove bacteria. All
instruments used during your surgery are sterilized to reduce your risk of
Pain control is an important concern. Near
the end of your surgery, your surgeon may inject a long-acting pain medicine at
the site of your surgery to decrease your pain for 6 to 12 hours after
Right after surgery, you will
be taken to a recovery area where nurses will care for and observe you. A nurse
will check your vital signs and bandages. He or she will also ask about your
When you wake up, you may have a small
tube just below your nose that supplies oxygen to your lungs.
You will most likely stay in the recovery area
for 1 to 4 hours. Then you will be moved to a hospital room or you will go
home. You may receive medicine or fluids through your vein (intravenous, or IV) during your time in the
Relief of any nausea or vomiting is an important
concern. If you will be going home the same day, you will need to drink fluids
without vomiting, be upright without fainting, and urinate on your own before
you will be sent home.
If you go home, the nurse will give you instructions on
breathing and exercises to help prevent any problems. For most minor surgeries,
the nurse will encourage you to be as active as possible to prevent these
Your doctor may give you medicine for pain.
Pain control remains an important concern after surgery. Inflammation or nerve injury from the surgery can cause pain. Your doctor may give you more than one medicine for pain. Often, opioids are given. In some cases, you may use a pain pump so that it's easy to get pain medicine right when you need it.
Typically, before you go home your doctors and nurses will make sure that:
The most common
problems after surgery are
pneumonia, bleeding, infection, clotted blood
(hematoma) at the surgery site, and reactions to the anesthesia.
In the first 48 hours after surgery, the most likely risks are bleeding
and problems with your heart or lungs.
From 48 hours to 30 days
after surgery, the most common risks are infection, blood clots, and problems
with other body organs, such as a
urinary tract infection.
Along with putting you to sleep during surgery, anesthesia can have side effects. Two of the most unpleasant ones are nausea and
While nausea will soon wear off, your constipation can leave you
uncomfortable for several days after your surgery. Your nurses can give you a
medicine to promote bowel movement. But eating may actually be the most
effective means of ending constipation, because food will push waste through
You may meet most of the criteria to go home but may not be able to
do certain things well enough to go home. In this case, you may go to a type of
assisted-living facility instead of to your home. Nurses and rehabilitation
specialists at an assisted-living facility can help you work toward getting
You will most likely go home with a sheet of
instructions including whom to contact if you have a problem.
A nurse will go over these instructions with you. He or
she can also help arrange for any care you will need when you go home. This may
include nursing care or visits from other health care workers.
Your instructions will include:
Your home-care instructions will include how to take care of your incision. The instructions
Your instructions will include when to have a follow-up appointment with
your surgeon. Your surgeon will want to talk to you before your follow-up
Call 911 or other emergency services right away if you have these symptoms:
Your recovery from surgery may be different from what
your surgeon expected. Other symptoms or problems may develop after your
surgery, even when you follow your surgeon's instructions. This can be very
Be sure to call your surgeon if you have an
unexpected symptom or problem, including:
This Web site has information for patients who are facing surgery. It helps patients and caregivers learn more about what types of questions to ask the primary care doctor and surgeon before surgery.
The American Society of Anesthesiologists (ASA) is a group of physicians who develop the medical standards of anesthesiology and seek to improve
patient care. The ASA website has information about pain relief, anesthesia during a procedure, and more.
This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health—from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest.
The National Institute on Aging (NIA) is one of the centers of the U.S. National Institutes of Health. This Web site has information about planning and paying for surgery.
Other Works ConsultedAntimicrobial prophylaxis for surgery. (2009) Treatment Guidelines From The Medical Letter, 7(82): 47–52.Costello AM, Bockstiegel R (2009). Preparing for surgery. In B Narins, ed., Gale Encyclopedia of Surgery and Medical Tests: A Guide for Patients and Caregivers, 2nd ed., vol. 4, pp. 1331–1337. Farmington Hills, MI: Gale.Doherty GM (2010). Postoperative care. In Current Diagnosis and Treatment: Surgery, 13th ed., pp. 24–32. New York: McGraw-Hill.Doherty GM (2010). Preoperative care. In Current Diagnosis and Treatment: Surgery, 13th ed., pp. 12–23. New York: McGraw-Hill.Ford-Martin P (2009). Recovery room. In B Narins, ed., Gale Encyclopedia of Surgery and Medical Tests: A Guide for Patients and Caregivers, 2nd ed., vol. 4, pp. 1366–1367. Farmington Hills, MI: Gale.Franz J, Bockstiegel R (2009). Post-surgical pain. In B Narins, ed., Gale Encyclopedia of Surgery and Medical Tests: A Guide for Patients and Caregivers, 2nd ed., vol. 4, pp. 1320–1324. Farmington Hills, MI: Gale.Grant PJ, Jaffer AK (2009). Preoperative assessment and care of the surgical patient. In EG Nabel, ed., ACP Medicine, section 8, chap. 4. Hamilton, ON: BC Decker.Gross RJ (2007). Preoperative planning for ambulatory patients. In NH Fiebach et al., eds., Principles of Ambulatory Medicine. 7th ed., pp. 1605–1633. Philadelphia: Lippincott Williams and Wilkins.Hardin RE, Zenilman ME (2010). Surgical considerations in the elderly. In FC Brunicardi et al., eds., Schwartz's Principles of Surgery, 9th ed., pp. 1709–1730. New York: McGraw-Hill.Hernandez AF, et al. (2004). Preoperative evaluation for major noncardiac surgery. Archives of Internal Medicine, 164(16): 1729–1736.Marquardt DL, et al. (2007). Postoperative management of the hospitalized patient. In WW Souba et al., eds., ACS Surgery Principles and Practice, 6th ed., pp. 77–86. New York: WebMD.Smeltzer SC, et al. (2010). Postoperative nursing management. In Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 12th ed., pp. 461–483. Philadelphia: Lippincott Williams and Wilkins.Smeltzer SC, et al. (2010). Preoperative nursing management. In Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 12th ed., pp. 425–441. Philadelphia: Lippincott Williams and Wilkins.
October 27, 2011
Anne C. Poinier, MD - Internal Medicine & Michel M. Murr, MD - General Surgery, Bariatric Surgery
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