General Information on Surgery

Getting your workup or evaluation

When you go to the doctor about a problem, you should be comfortable with both the doctor and the clinic. Look up their professional credentials, and ask people you trust for recommendations.

Make sure you understand the financial aspects of your care so you can avoid unneeded stress.

Your workup should include a history and a physical examination. After that, it is likely that there will be other diagnostic tests, such as blood work and imaging studies such as Ultrasound or MRI.

Discussing your diagnosis

Once all these are finished and the results have been reviewed, your diagnosis should be discussed with you on the phone or better, in an appointment. Once a diagnosis or even a " working diagnosis" (best guess) is made, a selection of approaches should be discussed. These can range from doing nothing, to medical treatment, to doing major surgery, and all in between. In most cases it is fairly easy to narrow this list of treatments to a couple best ones. Be sure you understand the pros and cons of each. Take more than one visit if you need to and bring your significant other if you wish. Be sure to write down all your questions in advance.

Treatments

As a general rule, we prefer to do the least invasive effective approach. Sometimes this is medicine rather than surgery ( medical treatment). If this is not the best choice, surgery is undertaken. In this case, we try to do the least invasive surgery that will do the job.

Preparing for surgery : The preop visit

If your plan includes surgery, you should have a special visit called a preoperative visit, or your " preop" . Here your diagnosis is reviewed, the surgery is described, and its risks, benefits, complications and alternatives are discussed. You should sign your consent papers for the surgery and you should discuss your preop orders. For more information on consent, click HERE.

You should also discuss what to expect after surgery. You should know how long you are likely to stay in the hospital, understanding that this depends entirely on how you do afterwards. You should have a rough idea about how you are going to feel, and what pain control options you may have. You should be given some guidance on how much help you are going to need at home and how long you will need to be off work.

Typical preop oders:

Almost universally there needs to be a certain period before surgery of having nothing by mouth. Usually this period is 8 hours. This includes liquids. However, often sips are allowed, especially if a medication is to be taken.
Preop orders include clarification about what usual medications are to be taken versus skipped. Oftentimes, doctors will ask patients to avoid certain medications 7-10 days before a surgery. These may have to do with thinning the blood. These would be ibuprofen, aspirin, and certain supplements such as ginseng. Other times, doctors give patients medications to purposely thin their blood before surgery. Be sure to know what you are supposed to do about this.
Orders may include special bowel cleansing procedures ( if needed)
Orders may include use of special stockings to prevent clots
Orders may include use of preop inhalers possibly
Orders may include preop antibiotics to be given.

Please make sure you understand your orders before you leave your preop appointment. Your case could get postponed if your instructions are not followed.

The post op period

Realistic expectations are the key to post operative recovery. Planning to need rest, pain medication and extra help is the best set of expectations to have.

Each surgery is different. We have produced some helpful post operative precautions and instruction sheets per procedure and have collected them HERE. They do have a common theme of common sense. Here are some of their other common themes:

Take it easy, but do not be bedridden.

Follow your post op instructions.

Stay well hydrated.

Keep your stools soft and urine clear.

Report any fever, chills, nausea, vomiting, diarrhea, uncontrolled pain, heavy bleeding, incisional separation, spreading redness or discharge.

Report any concerns whatsoever.

For more information about specific types of gynecologic and obstetric surgery, please see the specific surgery sections of this website yet to come.