Before Surgery

2. The Pre-Op Visit
Within one week prior to your surgery you will return to see your surgeon. During this visit he will review all of the laboratory data and consultations from other physicians to ensure that all is well for the surgery. He will also perform his own physical examination. Some laboratory tests will need to be repeated at this visit. Also during this visit your surgeon will obtain your consent for surgery. This will involve reviewing the potential benefits, risks, and alternatives to the planned treatment.

3. Admission To The Hospital
Usually, you will be admitted to the hospital the morning of your surgery. If you are from outside Sacramento (greater than 45 miles) and you are scheduled as the first case of the day, you have the option to be admitted at 8:00 p.m. the evening before. This is extended as a courtesy by the hospital (they are not paid for this) and therefore is subject to bed availability.

If you live within the Sacramento area, or you are scheduled as a second or later case, you will be admitted the morning of surgery. Whether you are admitted the night before or the morning of your surgery, there is little time available before surgery begins.

This means that the pre-admission procedures must be arranged as an outpatient at Sutter General Hospital; this is done through the Sutter Testing Service. You will visit the service within one week of your surgery. Normally this is done on the same day as your pre-operative visit with your surgeon. Appropriate lab tests will also be done on this visit to Sutter Testing Service.

Regardless of whether you are in the hospital or at home the day before surgery, you should take a shower and use a laxative suppository which will be given to you at the preoperative office visit. It is important to clean out the lower bowel prior to surgery because initially after surgery the bowels do not function normally and you usually will not have a bowel movement for several days. Therefore to avoid constipation and impaction, it is important to use a suppository before surgery. The morning of surgery you should also take a shower. This will help to decrease the bacterial count on your skin at the time of surgery. The blood thinner pill(s) also given to you at the pre-op visit should be taken the evening before your surgery.

4. Just Prior Surgery
If you are the first case, you will be taken to the pre-op holding area in surgery between 6:30 and 7:00 a.m. If you are the second or later case, you will be taken there approximately one hour prior to your scheduled surgery. When you arrive in the operating room area, you will be seen by the anesthesiologist and an intravenous line will be started in your arm.
The type of anesthetic to be used is a joint decision between yourself, your surgeon, and your anesthesiologist. Usually, a spinal anesthetic is recommended. This will numb you from the waist down. This type of anesthesia is advantageous because it decreases blood loss at the time of surgery and also decreases the chance of clots forming in the large veins. Narcotic pain medicine can also be placed in the spinal which will provide pain relief for up to 18 hours following the procedure. This provides excellent pain relief but does not cause sedation or addiction. In addition to the spinal anesthesia, it may also be necessary to use general anesthesia if the planned surgery is longer than 3 hours. If the spinal alone is used you will be given sufficient sedation to allow you to doze through the procedure but you will be arousable.