Important: This is intended as general information only. It may not apply to your specific situation.  It is not a substitute for medical advice.  If you have a question or concern, please raise it with me at your next appointment or contact me sooner if it's urgent.

Preparing for surgery

 

For most people, having surgery – even minor surgery – is an unfamiliar and confronting experience.  I will make every effort to make the process as smooth as ‘stress free’ as possible.  I am supported in this by the fantastic team of anesthetists, nurses and other staff at Epworth Freemasons who work together to create a calm, professional environment.  Feeling prepared can help alleviate some of the anxiety that inevitably comes with surgery.  Hopefully, you will have had plenty of opportunity to ask questions during our conversations in the rooms.  However, I always encourage patients to contact me by telephone if they have further questions, particularly in the lead up to surgery.  Of course, I will speak to you immediately prior to your surgery to answer any last-minute questions.  If there is something on your mind before this, please give me a call.

My staff will provide you with an admission letter explain when to come into hospital.  On the day before your surgery (which may be Friday if you are coming in on a Monday) the hospital will contact you by telephone or text message to confirm your exact admission time. 

 

Hospital Paperwork

You need to fill out some paperwork for the hospital.  This includes some basic demographic information as well as a short health questionnaire.  My office will provide you with the admission paperwork.  You can fill it out and post it back in a postage paid envelope (which will also be provided).  Alternately, you can fill in an online admission form which you can find in the Patient Information section of the Epworth website (Epworth.org.au). 

The admission paperwork also includes a Consent Form, which is how you give me official ‘permission’ to operate on you.  Usually, you and I will fill this out together when I see you in the rooms.  If you complete the online admission form rather than the hard copy, please bring the consent form with you when you come in for surgery.  If we have not completed a consent form in the rooms, you can leave it blank and we go through it together on the day of your surgery.

 

Fasting

It is important to fast before having a general anaesthetic.  This means nothing to eat for at least six hours before your surgery.  In practical terms, if you are having surgery in the morning, don’t eat anything after midnight the night before.  If you are having surgery in the afternoon, don’t eat anything after breakfast, which should be taken no later than 7am. 

However, you may continue to drink clear fluids up to two hours before surgery.  A clear fluid is anything that does not contain milk such as water, fruit juice, cordial, black coffee or black tea.  You need to avoid milky drinks including tea or coffee with milk.  You can drink up to 200mL of clear fluid per hour until two hours before surgery.  From two hours before surgery, you should avoid drinking anything.  If you are not sure whether something is a clear fluid or not, avoid it and have a drink of water instead. 

As well as avoiding food while fasting, you also need to avoid chewing gum, smoking and lollies.

Not fasting may increase the risks associated with your anaesthetic and may result in your surgery being delayed or cancelled.

 

What to Bring

Unless you’re staying overnight, it’s best to bring as little as possible.  Wear loose comfortable clothes that are easy to change in and out of.  It’s sensible to leave all removable jewelry at home.  You often spend some time waiting around before your surgery so you may want to bring a book or magazine to read to pass the time.

If you are staying overnight, bring pyjamas and loose comfortable clothes.  You should also bring any toiletries you think you will need as well as all your regular medications.  Please remove jewelry where possible.

You should also bring your Medicare card and private health fund details.   

Please bring your Consent Form if you have not already sent it in to the hospital.

 

Recovery

Most people recover well and quickly from surgery.   It’s recommended that you have a sensible adult at home with you for the first night after day procedure surgery.  If this is not possible, please talk to me about whether it might be a good idea to stay in hospital overnight.  If you have had a slow or difficult recovery from surgery or an anaesthetic in the past, please discuss it with me and my anesthetist before your surgery.  We will do everything we can to make this operation a better experience.  Understanding the problems you had last time can help with this.

Minor surgery

In general, after minor day procedure surgery (such as a hysteroscopy, D&C, endometrial ablation or LLETZ procedure) you can expect to fell pretty much back to normal the day after your surgery.  However, a general anaesthetic (even a quick, light one) can leave you feeling ‘not quite yourself’ for about 24 hours.  It is a sensible precaution to arrange the following day off work. 

After most of these procedures, you can expect to have a small amount of crampy period-type pain and light spotting for about 24 hours.  The pain should be mild and respond to simple pain killers like paracetamol and ibuprofen.

Day procedure laparoscopy

After day procedure laparoscopic surgery (such as treatment of endometriosis or an ovarian cyst), most people will require about one week off work.  The beauty oflaparoscopic (‘keyhole’) surgery is that it avoids the pain associated with a large cut in the abdomen and is therefore much less painful.  It does, however, involve a few small cuts, which you will feel.  Most people will require simple painkillers for a few days.   In addition, many people experience shoulder tip pain (due to gas left over from the laparoscopy irritating the diaphragm) for the first 24 hours. 

Major laparoscopy

After major laparoscopic surgery (such as a laparoscopic hysterectomy) you will be admitted to the ward.  Most people will spend two or three nights in hospital.  Although most people will require pain relief for only a few more days, you will find that you are generally tired and easily fatigued after this kind of surgery.  Most people will need to take four to six weeks off work.

Major open surgery

Surgery involving a laparotomy (a large cut in the abdomen, also known as open surgery) such as an open hysterectomy, involves a longer recovery.  You will spend a few days in hospital and will require pain killers at home for about two weeks.  You will need to plan for six weeks off work.

 

Follow up

We will make a plan for follow up before your surgery.  Depending on the procedure, I usually like to allow a few weeks to pass before arranging a routine review in the rooms.  This is to make sure that enough time has passes to judge whether the procedure has solved your problem.  If I am planning to take a biopsy or other pathology sample, we will make arrangements fordiscussing the results if these will be available before I see you in the rooms.  Of course, if you have concerns or problems before your planned postoperative review, I would like you to contact me and I will be happy to arrange an earlier review.

 

FAQs

Why has my surgery/admission time been changed?

This can be for many reasons.  It may be to ensure that the appropriate staff or necessary equipment is available for your procedure.  It may be necessary to change the order of the operating list due to other patients’ medical issues.  For example, it may be necessary to coordinate the timing of their surgery with their medications.  I recognize that these sorts of changes are inconvenient and will only make them when absolutely necessary.

Why have I been waiting so long?

When compiling an operating list, I estimate how long I think each patient’s procedure will take.  Most surgery is reasonably predictable, however some may be more complicated than expected and therefore take longer.  The theatre staff and I will endeavor to keep you informed if there are any delays. 

Occasionally and unexpected emergency (in my patient or one of my colleagues’ patients) may occur and your theatre time may be required.  The Epworth Freemasons Hospital incudes a Maternity Unit and occasionally our theatre may be required for an emergency caesarean section.  This does not happen very often.  I will keep you informed and give you a realistic expectation of when your procedure will take place.

When will my pathology results be available?

Most pathology results are available within a week, and many are within 48 hours.  We will make arrangements for discussing results before your operation.

What should I do if I have concerns after my surgery?

I encourage you to contact me directly if you have any concerns after your surgery.  I will ensure you have my contact details before you go home 

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