Surgery Information: What to Expect Before, During, and After

Comprehensive Surgery Information: From Consultation to Recovery

Surgery is a field of medicine that focuses on the operative treatment of diseases, injuries, and deformities. It is an integral part of healthcare, providing treatments for a wide variety of conditions ranging from minor cuts to major organ transplants. Surgeries can be incredibly complex and range from minimally invasive procedures to extensive operations utilizing advanced medical technology. They require precise skill and an insistence upon high standards of safety in order to ensure the best possible outcome for the patient. As such, surgeons must undergo rigorous training before they are able to perform surgeries. Preoperative and postoperative care are essential components of any surgical procedure and can significantly reduce surgical risks while enabling surgeons to perform more complex procedures safely. Please keep reading for details on the following topics:

Types of surgeries

Members of the surgical team

What occurs before surgeries

Conditions that increase the risk of surgeries

Tests done before surgeries

Preoperative care

Risks of surgeries

Types of surgeries

Types of surgeries encompass minor, major, and emergency procedures, each varying in complexity and necessity, from routine cyst removals to life-saving interventions.

MINOR SURGERY

Minor surgeries are typically done in an office or outpatient setting; they may involve local anesthesia, usually a simple procedure such as the removal of a cyst. They usually last a few hours, and the patients do not require hospitalization.

MAJOR SURGERY

Major surgeries on the other hand, are more extensive and involves general anesthesia. These types of surgeries are usually done in a hospital or operating room setting and may include operations to repair broken bones, remove tumors, or transplant organs.

EMERGENCY SURGERY

Emergency surgeries are conducted when time is critical; lifesaving procedures are performed when someone has suffered an injury from an accident or heart attack. Regardless of which type of surgery is being performed, precision, skill, and careful preparation are paramount for successful outcomes. The patients require hospitalization.

MEMBERS OF THE SURGICAL TEAM

The surgical team comprises various professionals who collaborate to ensure the success and safety of surgical procedures. Key members include:

Lead Surgeon: The primary physician responsible for performing the surgical procedure, making critical decisions during surgery, and coordinating the team.
Assistant Surgeon: Supports the lead surgeon during the operation by assisting with surgical tasks, providing additional expertise, and ensuring smooth workflow.
Surgical Technician: Assists by passing instruments and equipment to the surgeon, maintaining a sterile field, and helping with other technical aspects of the procedure.
Registered Nurse (RN): Provides nursing care before, during, and after surgery, documents surgical details, monitors the patient’s condition, and ensures adherence to safety protocols.
Anesthesiologist: Administers anesthesia, monitors the patient’s vital signs throughout the surgery, and manages pain control to ensure the patient’s comfort and safety.
Operating Room (OR) Nurse: Assists the surgical team by managing surgical equipment, maintaining a sterile environment, and providing direct patient care during surgery.
Surgical Assistant: Provides additional support to the surgical team by assisting with various tasks, such as suturing, retracting tissues, and controlling bleeding.

WHAT OCCURS BEFORE SURGERIES

Before undergoing surgery, several important steps and preparations are necessary to ensure the best possible outcome for the patient. Here’s a comprehensive guide to what should be done before a surgery:

Schedule an Appointment with the Surgeon: Arrange a consultation with the surgeon to discuss the procedure, ask questions, and gain a clear understanding of the treatment plan. The surgeon will explain the reason for the surgery, exactly how the procedure will be done, risks and expected outcome and the recovery period.
Informed Consent: The surgeon will explain the reason for the surgery, the surgical procedure itself, potential risks and complications, expected outcomes, and the recovery process. The patient must provide informed consent before the surgery can proceed.
Preoperative Assessment with a Nurse: Meet with a nurse who will review and complete necessary paperwork, verify personal information, provide instructions for preoperative fasting, and gather health history information.
Preoperative Instructions: Patients will receive specific instructions regarding preoperative preparations, which may include fasting guidelines, medication adjustments, and personal hygiene instructions.
Medical Clearance: Depending on the patient’s medical history and the complexity of the surgery, medical clearance from other specialists, such as a cardiologist or pulmonologist, may be required.
Diagnostic Tests: Various diagnostic tests may be ordered to assess the patient’s health status and determine surgical candidacy. These tests may include blood tests, urine tests, imaging studies (X-rays, CT scans), electrocardiogram (EKG), and other assessments.
Medication Adjustments: Patients may be advised to stop certain medications before surgery, especially blood thinners or NSAIDs, to reduce the risk of bleeding during the procedure.
Preoperative Fasting: Patients are typically instructed to refrain from eating or drinking anything for a specified period before surgery, usually starting the night before the procedure. This helps prevent complications related to anesthesia and reduces the risk of aspiration during surgery.
Personal Preparation: Patients should arrange for transportation to and from the hospital or surgical center on the day of the procedure. They should also plan for postoperative care and recovery accommodations, including assistance from family members or caregivers if needed.
Physical Preparations: Follow any additional instructions provided by the surgical team, such as showering with a special antibacterial soap before surgery, removing nail polish and jewelry, and wearing loose, comfortable clothing on the day of the procedure.
Emotional Support: Patients may experience anxiety or stress before surgery, so it’s essential to seek emotional support from loved ones, friends, or healthcare professionals if needed.

CONDITIONS THAT INCREASE THE RISK OF SURGERIES

Here are some common conditions and factors that may elevate surgical risk:

Diabetes: Poorly controlled diabetes can impair wound healing and increase the risk of infection. It can also lead to complications such as diabetic neuropathy and cardiovascular issues.
Heart Problems: Conditions such as coronary artery disease, heart failure, arrhythmias, or previous heart attacks can increase the risk of cardiovascular complications during surgery.
Presence of a Pacemaker: Patients with pacemakers may require special precautions during surgery to avoid interference with the device and maintain proper cardiac function.
Lung Diseases: Chronic lung conditions like asthma, chronic obstructive pulmonary disease (COPD), or pulmonary fibrosis can impair respiratory function and increase the risk of postoperative complications such as pneumonia or respiratory failure.
Sleep Apnea: Obstructive sleep apnea can lead to complications during anesthesia and increase the risk of respiratory complications, including airway obstruction and oxygen desaturation.
Allergies: Known allergies to medications, latex, or other substances must be carefully managed to prevent allergic reactions during surgery.
Bleeding Disorders: Patients with bleeding disorders such as hemophilia or thrombocytopenia are at increased risk of excessive bleeding during and after surgery.
Anticoagulant Therapy: Taking blood-thinning medications such as warfarin, aspirin, or direct oral anticoagulants can increase the risk of bleeding during surgery and may require adjustments or temporary discontinuation before the procedure.
Fever: Elevated body temperature may indicate an underlying infection or inflammatory condition, which can increase the risk of surgical complications and delay healing.
Substance Use: Tobacco smoking, excessive alcohol consumption, and illicit drug use can impair wound healing, increase the risk of infection, and lead to complications such as delayed recovery and poor surgical outcomes.
Pregnancy: Pregnancy poses unique challenges during surgery, including changes in physiology, increased risk of thromboembolic events, and potential harm to the fetus from anesthesia or surgical interventions.
Metal Implants or Fragments: Pre-existing metal implants or fragments in the body can pose risks during certain surgical procedures, such as interference with imaging equipment or surgical instruments.

TESTS DONE BEFORE A SURGERY

Here are some common tests performed before surgeries:

Blood Tests: Comprehensive blood tests, including complete blood count (CBC), blood chemistry panel, and coagulation studies, are performed to assess overall health, detect underlying medical conditions, and evaluate blood clotting function.
Urine Tests: Urinalysis may be conducted to screen for urinary tract infections, kidney function abnormalities, or other urinary system issues that could affect surgical outcomes.
COVID Test: In situations where infectious disease control is crucial, such as during the COVID-19 pandemic, patients may undergo preoperative testing for SARS-CoV-2 to reduce the risk of transmission to healthcare providers and other patients.
Blood Clotting Tests: Coagulation studies, including prothrombin time (PT), activated partial thromboplastin time (aPTT), and international normalized ratio (INR), are performed to assess blood clotting function and identify bleeding disorders or abnormalities that may increase the risk of intraoperative or postoperative bleeding.
X-rays: Imaging studies, such as X-rays, may be ordered to evaluate the skeletal system, assess bone density, or detect any abnormalities that could impact the surgical procedure.
Electrocardiogram (EKG): An EKG is often performed to assess cardiac function, detect arrhythmias, and identify any underlying cardiovascular conditions that may pose risks during surgery.
Assessment by a Cardiologist: Patients with a history of heart disease, hypertension, or other cardiovascular conditions may undergo a preoperative evaluation by a cardiologist to assess cardiac function, optimize management of cardiovascular risk factors, and determine the patient’s fitness for surgery.
Pulmonary Function Tests: Patients with known or suspected respiratory conditions, such as asthma or COPD, may undergo pulmonary function tests to assess lung function and respiratory reserve, which can help guide anesthesia management and predict postoperative respiratory complications.
Imaging Studies: Depending on the type of surgery and the specific medical conditions involved, additional imaging studies such as CT scans, MRI scans, or ultrasound may be ordered to evaluate the anatomical structures, identify lesions or abnormalities, and assist with surgical planning.
Other Specialized Tests: Depending on the patient’s medical history, surgical procedure, and individual risk factors, additional specialized tests or consultations may be required, such as echocardiography, stress testing, or consultation with other medical specialists.

PREOPERATIVE CARE

Preoperative care involves preparing both the patient and the operating room for surgery, as well as any necessary tests or laboratory work. Preoperative care often includes taking the patient’s health history, doing a physical examination, administering specific lab tests and imaging studies, informing patients about potential risks associated with their procedure, and providing psychological preparation.

Here’s a detailed checklist of important steps to take before all surgeries:

Seek Blood Donors: In cases where blood transfusion may be necessary during or after surgery, arrange for potential blood donors as a precautionary measure.
Bring Test Results: Bring all the results of diagnostic tests done before surgery to provide comprehensive information to the surgical team.
Preoperative Fasting: Follow the instructions provided by your healthcare team regarding fasting before surgery. Typically, patients are required to avoid eating or drinking anything for a certain period before the operation to reduce the risk of aspiration.
Stop NSAIDs: Discontinue the use of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) at least a week before the scheduled surgery, as they can increase the risk of bleeding during the procedure.
Leave Valuables at Home: Avoid bringing valuables such as jewelry, watches, or large sums of money to the hospital. It’s best to leave these items at home to prevent loss or theft.
Bring Necessary Medical Devices: If you have asthma or mobility issues requiring a cane, ensure you bring your asthma inhaler or cane with you to the hospital for use before and after the surgery.
Arrange Transportation and Support: Arrange for a support person or transportation home after the operation, as you may not be able to drive yourself due to the effects of anesthesia or postoperative pain.
Shower and Avoid Lotions/Colognes: Shower before the operation using regular soap, but avoid applying lotions, perfumes, or colognes to the skin, as they can interfere with surgical preparations.
Remove Nail Polish and Jewelry: Remove all nail polish, acrylic nails, and jewelry, including rings, earrings, bracelets, and necklaces, before the surgery. This helps prevent contamination and interference with surgical procedures and monitoring devices.

The operating room nurse will:

Verification of Information: The healthcare team verifies the patient’s identity, confirming details such as name, date of birth, and any known allergies. They also ensure that the patient has signed the consent form for the surgery, indicating their agreement to proceed.
Confirmation of Surgical Site: Prior to surgeries, the surgical team check the correct body area where the procedure will be performed. This is crucial to prevent wrong-site surgery and ensure that the intended surgery is carried out on the correct patient.
Addressing Patient Concerns: Any doubts or questions the patient may have about the procedure are clarified by the healthcare team. Providing reassurance and addressing concerns helps alleviate anxiety and build trust between the patient and the medical staff.
Assessment of Vital Signs: Vital signs such as blood pressure, heart rate, respiratory rate, and temperature are assessed to ensure the patient’s overall health and stability before surgery.
Measurement of Weight: The patient’s weight is measured as part of the preoperative assessment. This information may be used to calculate medication dosages or monitor fluid balance during and after surgery.
Explanation of Procedure: The healthcare team explains the surgical procedure to the patient, including what to expect before, during, and after surgery. This helps the patient feel more informed and prepared for the upcoming procedure.
Providing Hospital Gown: The patient is provided with a clean hospital gown to wear during the surgery. Wearing a hospital gown ensures sterility and facilitates access to the surgical site for the medical team.
Removal of Dentures, Hearing Aids, and Contact Lenses: Dentures, hearing aids, and contact lenses are removed before surgery to prevent interference with the procedure and minimize the risk of damage or loss.
Administration of Medication: Depending on the patient’s individual needs and the planned procedure, medication may be administered before surgery. This may include fluids to maintain hydration, antibiotics to prevent infection, and antiemetics to prevent nausea and vomiting.
Informing Relatives: The patient’s relatives are informed about the expected duration of the operation and provided with information about where they can wait during the surgery. Keeping family members informed helps alleviate their concerns and ensures they are prepared for the patient’s surgery.

The surgical team plays a crucial role in ensuring the patient’s safety and well-being throughout the surgical process. Here’s an overview of their responsibilities:

Inform the Patient about the Surgery: The surgical team provides information to the patient about the procedure, including the equipment used during the operation such as an IV, urinary catheter, or wound drains. This helps the patient understand what to expect during the surgery.
Answer Last-Minute Questions: Any last-minute questions or concerns the patient may have about the surgery are addressed by the surgical team to alleviate anxiety and ensure the patient feels informed and comfortable.
Confirm Patient Identity and Operation Site: Prior to surgery, the surgical team verifies the patient’s identity and confirms the correct surgical site to prevent errors or complications.
Insert Breathing Tube: For patients receiving general anesthesia, a breathing tube is inserted to maintain an open airway and ensure adequate oxygenation during the procedure.
Prepare Surgical Site: The skin over the operating site is washed and marked to maintain cleanliness and facilitate accurate incision placement.
Transfer to Recovery Area: After the operation, the patient is transferred to a designated recovery area where they are observed and cared for by a recovery nurse. This ensures that any immediate postoperative needs are addressed promptly.
Monitor Vital Signs and Pain Level: The recovery nurse monitors the patient’s vital signs, including heart rate, blood pressure, and oxygen saturation, as well as assesses pain levels and manages pain medication as needed.
Provide Oxygen: A small tube (nasal canula) is placed just below the nose to supply oxygen to the lungs and support respiratory function during the recovery period.
Postoperative Care: The patient remains in the recovery room for up to 4 hours, during which time they may receive medication or fluids through an intravenous (IV) line as needed. Patients undergoing general or spinal anesthesia may be required to remain in a supine position for 6 to 12 hours to minimize postoperative complications.
Encourage Activity: Once fully recovered from surgery, patients are encouraged to be as active as possible to promote blood flow within the body and reduce the risk of complications such as blood clots.

RISKS OF SURGERIES

Here are some common risks associated with surgery:

Infection: Surgeries increase the risk of infection, both at the incision site and within the body. Despite strict sterile techniques, bacteria can still enter the body during a surgery, leading to infections such as surgical site infections, urinary tract infections, or pneumonia.
Bleeding: Bleeding is a common risk during and after surgeries, especially for procedures involving major blood vessels or organs. Excessive bleeding (hemorrhage) can lead to complications such as anemia, hypovolemic shock, or the need for blood transfusions.
Blood Clots: Surgery and immobility during the recovery period can increase the risk of blood clots forming in the veins (deep vein thrombosis) or traveling to the lungs (pulmonary embolism). Blood clots can be life-threatening if not promptly diagnosed and treated.
Anesthesia Complications: Anesthesia carries its own set of risks, including allergic reactions, respiratory depression, aspiration (inhaling stomach contents into the lungs), and cardiovascular complications such as hypotension or arrhythmias.
Organ Damage: Surgeries can inadvertently damage surrounding organs or tissues, leading to complications such as organ perforation, nerve injury, or impaired organ function.
Delayed Healing: Some patients may experience delayed wound healing, which can prolong recovery time and increase the risk of infection or other complications.
Scarring and Disfigurement: Depending on the type of surgery and the individual’s healing process, scarring or disfigurement may occur at the incision site. Cosmetic surgeries, in particular, carry the risk of unsatisfactory aesthetic outcomes.
Pain and Discomfort: While pain management techniques have improved, some degree of pain or discomfort is common after surgery. Inadequate pain control can lead to prolonged recovery, decreased mobility, and impaired quality of life.
Allergic Reactions: Patients may experience allergic reactions to medications, surgical materials (such as sutures or implants), or other substances used during surgery.
Complications Specific to the Procedure: Certain surgical procedures carry unique risks and complications based on the type of surgery performed, the area of the body involved, and the patient’s underlying health conditions.
Hematoma: A hematoma is a localized collection of blood outside of blood vessels, usually due to trauma or injury to blood vessels during surgery. It occurs when blood leaks from damaged blood vessels into surrounding tissues, creating a pocket of blood that can cause swelling, pain, and discoloration. Hematomas can vary in size from small bruises to larger, more painful collections of blood.

Disclaimer: The information provided in this content is for general informational purposes only. It is not intended as medical or healthcare advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare professional with any questions you may have regarding a medical condition or healthcare decisions.