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Overview

Operations
Operations

If you're considering having an operation or your GP has suggested you may need surgery, this guide is for you.

It will take you through all the steps in the process, from referral to recovery, so you're fully prepared and know what questions to ask at each stage.

Before you start the treatment journey, your GP will refer you to see a specialist at a hospital.

Find out more about each stage of the treatment journey by following the below steps:

  • Seeing a specialist- an initial consultation to discuss your treatment options and agree what's right for you.
  • Preparing for surgery - what to do in the days leading up to surgery, and your pre-operative assessment.
  • Day of the operation - arriving at hospital, information for visitors, and what happens before you go into theatre.
  • After surgery- coming round from the operation and being discharged from hospital.
  • Getting back to normal - general advice and typical recovery times.
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Seeing a specialist

Your first appointment will be with a consultant or another member of the surgical team. You can bring someone with you to this appointment.

At this stage, it is not guaranteed that surgery will be right for you. Only the consultant can make this decision, after doing some tests, making a careful assessment and weighing up all the treatment options that are available to you.

You may want to ask your specialist the following questions:

  • What are the different types of treatment for my condition?
  • What are the benefits, side effects and risks of each of these treatments?
  • Why are you recommending that I have this operation?
  • Are other types of non-surgical treatment possible for my condition?

If an operation is necessary, this will be your chance to find out what the operation involves, why it's needed, and whether it's suitable for you.

Here are some questions you may want to ask:

  • Who will perform the operation? What qualifications and experience do they have?
  • What exactly does the operation involve, and how long will it take?
  • What type of anaesthetic will I need?
  • How long is the waiting list for this operation?
  • How will I know if the operation is a success?

Also, don't be afraid to ask practical questions, such as:

  • Will I need stitches and will there be scarring?
  • How long before the operation will I need to stop eating and drinking?
  • How long will I need to stay in hospital?
  • How long will it take me to recover and get back to normal?
  • Will I need time off work and, if so, for how long?

Make sure you discuss any concerns with the consultant.

You may wish to ask if there's any written information about the operation or procedure you can take away with you.

At the end of the session, your consultant may book your operation or ask you to come back for a further appointment.

Once booked, you should receive a letter with details of your operation, asking you to confirm you are happy with the proposed date and time.

Giving your consent

Before having a planned operation, your consent should be obtained by the surgoen well in advance.

This is to ensure you have plenty of time to examine any information about the procedure and ask questions.

You're entitled to withdraw previous consent if you change your mind at any point before the operation.

Read more about consent to treatment.

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Getting Ready

In the days leading up to your surgery, you'll need to make travel arrangements for getting to and from the hospital and think about what to pack.

Make sure you give your family and friends plenty of notice about your operation, so they can take time off work to be with you if necessary.

Check your hospital's policy on visiting times and let your family and friends know.

Pre-operative assessment

At some hospitals you'll be asked to attend a pre-operative assessment, which may be an appointment with a nurse or doctor or a telephone assessment. 

You'll be asked questions about your health, your medical history and your home circumstances.

If the assessment involves a visit to the hospital, some tests may be carried out.

This is to check if you have any medical problems that might need to be treated before your operation, or if you'll need special care during or after the surgery.

The tests you have will depend on what operation and the knid of anaesthetic you're having.

These tests might include blood tests, urine tests and pregnancy test for women.

This assessment will usually happen one or more days before your operation.

Make sure you know the results of any previous test, as well as all medications, vitamins and herbal supplements you take.

You'll be given clear information on:

  • whether you need to stop eating and drinking in the hours before your operation
  • whether you should stop taking your usual medications before going into hospital
  • what to bring with you into hospital
  • whether you'll need to stay in hospital overnight and, if so, for how long

Importance of not eating (fasting)

If your doctor has instructed you not to eat (fast) before the operation, it's really important that you don't eat or drink anything - this includes light snacks, sweets and water.

You need an empty stomach during surgery so you don’t vomit while you are under anaesthetic.

If you take insulin because of diabetes you'll still need to avoid eating and drinking before surgery, but make sure your medical team is aware of your condition, so appropriate precautions can be taken.

Hygiene

You'll need to remove all body piercings, make-up and nail polish before your operation. 

This can help to reduce unwanted bacteria being brought into the hospital. It also helps doctors to see your skin and nails to make sure your blood circulation is healthy.

Some hospitals may request that you have a bath or shower before coming in for your surgery, or have one once you arrive.

What to pack for hospital

If you're staying in hospital, you may wish to pack:

  • a nightdress or pyjamas
  • day clothes
  • clean underwear
  • dressing gown and slippers
  • small hand towel
  • toiletries - soap, toothbrush, toothpaste, shampoo, deoderant
  • sanitary towels or tampons
  • razor and shaving materials
  • comb or hairbrush
  • book or magazines
  • small amount of money
  • medication you normally take, and a list of the doses for each medicine
  • glasses or contact lenses with case
  • notebook and pen
  • healthy snacks
  • address book and important phone numbers, including your GP's and contact details

You may want to check with your hospital about their policy of the use of mobile phones, MP3 players and laptops or tablets during your hospital stay.

Remember to bring your appointment card or admission letter with you, too.

Getting to and from hospital

Think about how you will get to the hospital and back again. You probably won't be well enough to drive, so you may want to arrange transport or ask a friend or relative to help.

In some cases, the hospital may be able to arrange transport home for you.

Cancelling and rearranging

If you're unable to attend your hospital appointment or you don't feel well enough to have your operation, let the hospital know as soon as possible. They'll be able to talk to you about rearranging the appointment.

Let your surgeon know if you develop a cough, cold or fever a few days before surgery. They will advise whether your operation can go ahead.

 

 

 

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What happens?

Your admission letter from the hospital will tell you the date and time of your operation and what time you need to arrive.

It should also tell you which ward or department you're going to be in, a contact number for your hospital or ward and the consultant who will be taking care of you.

When you arrive, you'll be welcomed by a member of staff, who will explain the processes to you and give you an identity bracelet to wear during your stay in hospital.

During your time in hospital, you may be asked the same questions by several people. This is routine, and it ensures that the correct information about you is checked and available at each stage of treatment.

You may want to ask some questions of your own, such as:

  • What happens before the operation?
  • Why do I have to wear the surgical stockings?
  • Can I still eat and drink before the operation?
  • What will I feel like after the operation?
  • How long will the effects of the anaesthetic last?
  • Will I feel any pain after the operation?
  • How will my pain be managed after the surgery?
  • What should I do and who should I tell if I'm in pain?
  • What are the visiting arrangements?
  • Will I return to the same ward after the surgery?
  • When will I see the consultant?
  • When can I expect to go home after the operation?
  • When will I be told of any results of samples taken?

Medication

Take any medicines that your doctor asked you to take before surgery. However, if you normally take tablets or insulin for diabetes, make sure that you discuss this with your specialist as soon as possible before your operation.

You'll be asked whether you're allergic to any medication or whether any relatives have ever had any problems with an anaesthetic, so that suitable precautions can be taken.

Visitors

Family or friends can usually stay with you until you leave for the operating theatre, at which point they can wait for you in the waiting room. 

You can ask the hospital for their policy on visiting times.

Just before the operation

You'll be asked to get undressed and change into a hospital gown. The details of the operation will be explained to you.

For many operations, a needle connected to a drip will be put into your hand. This allows fluids, nourishment and medicine to be given while you're under anaesthetic.

Anaesthesia

You will be given an anaesthetic so that you won’t feel any pain during the operation.

A general anaesthetic will be needed for a major operation, which means you'll be asleep throughout the whole operation. It will be given to you via an injection or gas, which you breathe through a mask.

There's no need to be anxious about having a general anaesthetic: the anaesthetist will be by your side the whole time you are asleep, carefully monitoring you, and will be there when you wake up.

If you don't need to be put to sleep, you'll be given a regional anaesthetic. This means you’ll be conscious throughout, but you won't feel any pain.

It may be a local anaesthetic, where a small area is numbed, or an epidural, which reduces sensation in the lower areas of your body.

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Afterwards

After surgery, you'll be moved back to the ward (after local anaesthetic) or a recovery room (after general anaesthetic or epidural), where you'll be told how the operation went.

You may feel hazy or groggy as you come round from the anaesthetic. A nurse will give you oxygen (through tubes or a mask) to help you feel better.

It's common to feel sick or vomit after you've been given anaesthesia. Your nurse may offer you medicine to help relieve this discomfort. You may also have a sore throat and dry mouth.

Your blood pressure will be taken via an automatic cuff that squeezes tightly at regular times. Your temperature will also be taken.

The outcome of your operation

It's important to find out how well your operation went. 

Here are some questions you may want to ask:

  • Was the operation as successful as expected?
  • What effect has the operation had on my condition?
  • How will I expect to feel when I get home?
  • How long will it be before I'm back to normal?

Managing pain

You'll always have some pain after having surgery.  Tell your nurse as soon as you start to feel any pain so they can give you painkilling medication as soon as possible.

This will stop it getting worse (medication can take 20 minutes to start working) and improve it.

Avoiding blood clots

The sooner you can start to move around, the better. Lying in bed for too long can cause some of your blood to pool in your legs. This puts you at risk of a blood clot.

If possible, doing some leg exercises can help to prevent a blood clot. These may be as simple as flexing your knee or ankle and rotating your foot.

You may be given special support stockings to wear after surgery to help your blood circulation. Your nurse or doctor will explain how you should use these. 

Some people are given an injection to thin the blood slightly to help reduce the risk of clots.

Enhanced recovery

Research shows the earlier you get out of bed and start walking, eating and drinking after your operation, the better.

Your hospital may offer an enhanced recovery programme if you've had major surgery. This rehabilitation programme aims to get you back to full health quickly, which means you could go home sooner than traditionally expected.

Plan for your days following surgery

It's important to arrange for appropriate care following your operation. For elderly patients, it's important to arrange for suitable equipment and care.

You shouldn't be afraid to ask for things that may help you, such as a wheelchair or walking frame.

Discharge

Before you leave hospital you may (depending on the type of operation you had) have an appointment with a physiotherapist, who will be able to advise you about any exercises you need to carry out.

You'll also be given advice about how to care for your wound, any equipment you may require, such as dressings, bandages, crutches and splints, and maybe a dose of painkillers.

Each hospital will have its own policy and arrangements for discharging patients.

Your discharge will be affected by:

  • how quickly your health improves while you're in hospital
  • what support you'll need after you return home

You may want to ask some questions before you leave hospital, such as:

  • Who should I call if I have any concerns once I'm home?
  • What should I be trying to do on my own – for example, going to the bathroom and getting out of bed?
  • Is there anything I should avoid doing?
  • When can I go back to work?
  • How much pain, bruising or swelling should I expect when I get home?
  • When and where will any stitches be removed?
  • Do I need to return to hospital or my GP for follow-up? If so, when will this be?

Read more about leaving hospital, which includes information on discharge.

Transport home

You won’t be able to drive yourself home after surgery – get someone to pick you up or take you home in a taxi.

It's a good idea to have an adult available to help you for at least 24 hours after surgery.

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Recovery

Don't be surprised if you feel very tired when you get home, especially if you've had a major operation or a general anaesthetic.

You should only do as much as you feel able to in the days after your operation.

But it's important to try to move around as soon as possible and follow your doctor's advice on getting active again.

This will encourage your blood flow and your wounds to heal, and will build up strength in your muscles.

Generally, try to get back into your regular routine as soon as possible.

Use this as an opportunity to make a fresh start: to eat more healthilystart exercising to stay in shape, and (if you're a smoker) quit smoking.

If you have a dressing on the area that was cut for the operation, follow the instructions your nurse gave you to care for your wound at home.

How to tell if you might have a blood clot

Signs to look out for after your operation include:

  • pain or swelling in your leg
  • the skin of your leg feeling hot or discoloured
  • the veins near the surface of your leg appearing larger than normal

Read more about the symptoms of deep vein thrombosis. If you experience any of these symptoms, seek medical help immediately.

Recovery

Your doctor will have given you an idea of how long it will take to get back to normal.

The following links provide information and advice about recovering from specific procedures:

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The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website nhs.uk
Last Updated: 18/07/2018 15:12:55