The Day of Your Surgery
*Modified from Surgery Guides (uhn.ca)
Once you arrive, please go to the Pre-Operative Care Unit (POCU)
You will be checked in by the ward clerk and your nurse double checks your name, date of birth and chart information. They will also make sure that you have a wristband that has your name. If you have allergies or you are at risk of falling while in hospital, we will give you separate allergy or falls risk armband. These will be checked before you go for your surgery.
You change into a hospital gown and you will be placed in either a recliner or on a stretcher (depending on your surgery). The nurse will place a warming blanket on you to help keep you warm before and during your surgery. This helps lower the chance of infection. You will also be given a disposable hair cap in which you should place all your hair until your surgery is over.
Shortly before your procedure, your anesthesiologist will meet you to review your medical history and to perform a short pre-operative assessment. This will be similar to the one performed at your pre-admission consult and will act to confirm that the anesthetic plan they created for you is optimized based on your most-up-date health status. An intravenous (IV) may be started in your arm and, you may be given medication to help you relax.
Afterwards, members of your surgeon and other members of your surgical team will meet you to review your health. At this point, your surgeon will confirm with you the area on your body where the surgery will happen. They will use a special marker to mark the area. We won’t take you to the operating room until the site is marked. Please don’t mark your body yourself before your surgery.
If you are admitted as an inpatient after surgery, you will have your blood sugar tested in POCU and Post-Anesthetic Care Unit (PACU) so we can monitor your blood sugar levels.
When it is time, a member of your healthcare team will take you to your OR. When you arrive, members of the surgical team, your anesthesiologists and OR nurses will be present to welcome you. Once inside, you will be asked to lay on your back on the OR table and several sensors will be attached. These sensors are used to monitor your vitals (heart rate, blood pressure, oxygen levels, etc.) during your operation.
Before your surgery begins, we will review all of the important information about you out loud. This is called a time out. This makes sure that the operating room team understands and agrees with what they will do. At this point we also confirm the procedure and the site of your surgery. Next, your anesthesia team will give you medications that will put you to sleep through your intravenous (IV) line. Some of these medications may create a light burning sensation that will wear off in seconds; you should fall asleep immediately after this point. In many cases, your anesthetist will choose to have you under general anesthesia, in which case they will insert a breathing tube that will be used to protect your airway and control your breathing; this is called intubation.
Your surgical team will then prepare you for the operation. They will put pads and cushions under your bony areas (elbows, ankles). This prevents any pain and discomfort during your surgery.
If needed, some of your body hair will be removed just before the sites of your incisions are sterilized. Please do not shave or clip your body hair in the area of your surgery at home as this can increase your chance of getting an infection. To sterilize your skin, a reddish purple solution will be applied to your skin and left to dry. You may notice skin discoloration where it was applied after your procedure.
In many cases, your surgical team will insert a foley catheter due to the length of your surgery. This is a catheter that is placed along the full length of your urinary tract in order to drain any urine accumulating in your bladder during your procedure. Best practice requires that the catheter be removed in the first 24 hours after your procedure. An exception is made for some rectal surgeries; the catheter is removed within 48 hours instead. Although not common, once your surgery is done, drains may be left inside your abdomen to help prevent accumulation of fluids during your recovery.
To learn more about the specific surgeries you may undergo, please refer to the Surgical Techniques section.
Once your surgery is over and you are awake, you will be transferred to the recovery room in PACU. There you will be monitored and cared for by a team of nurses that will either organize your transfer to an inpatient ward or prepare you for your discharge home. Your surgical care team will have organized for you to receive medications for any pain, nausea or vomiting that you might experience afterwards. You will also receive fluids through your IV line until we determine that it is safe for you to start drinking clear fluids again.
Common symptoms you may experience after surgery include:
Because of some of the medications used by your anesthetist during your surgery, you may experience grogginess during the first day after your procedure. As you recover, a member of our surgical team will contact your family or loved ones to let them know how your surgery went.
What happens next?
When will I see my surgical team: if you are alert enough, we will speak to you briefly in the recovery room right after your surgery. However, as it may take some time for anesthetic medications to wear off, we will most likely visit you in the evening following your surgery. By then and if you are being admitted as an inpatient, you will also have been transferred to an inpatient bed and have many of your postoperative symptoms being actively managed.
Minimizing your pain is one of our priorities. We aim to reduce post-surgical pain by using a multi-modal approach to treating it. This generally means that we will use multiple types of pain medications such as Tylenol®, Advil® and opioids to reduce your pain. Although opioids can be more potent analgesics, we try to reduce the doses given to you as they can be associated with side effects such as nausea, vomiting and constipation.
In some cases, we may set you up to control your own pain management using “patient-controlled analgesia,” or IV pumps that let you administer pain medications yourself whenever you feel that your pain level is too high. Your surgeon will discuss whether this is an appropriate option for you.