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Patient Instructions

On the day of your consultation, please arrive 15 minutes early.  Please bring your current medication list and any imaging or records from outside PAMF, Good Samaritan Hospital or O'Connor Hospital. 



General Instructions (see below)
Laparoscopic Cholecystectomy (removal of the gallbladder)
Laparoscopic Ventral Hernia Repair
Laparoscopic Inguinal Hernia Repair
Open Inguinal Hernia Repair
Laparoscopic Colon Resection
   -- Low residue diet (for use after colon surgery)
Hemorrhoidectomy
Examination Under Anesthesia, Botox of the Anal Sphincter (for fissure)
Transanal Excision of Low Rectal Tumor
Laparoscopic Nissen Fundoplication
Laparoscopic Paraesophageal Hernia Repair and Nissen Fundoplication
Splenectomy
Distal Pancreatectomy
Adrenalectomy
Thyroidectomy
Parathyroidectomy

GENERAL INSTRUCTIONS PRIOR TO SURGERY

Before your operation:

·You should take all your home medications, including aspirin, unless instructed otherwise. Please ask specifically about any medications for diabetes.  If you are on Coumadin (Warfarin) or other potent blood thinner such as Plavix, Xarelto, etc, be sure your surgeon is aware of this before the procedure. She may ask you to stop the blood thinner well in advance of the procedure.

·You should shower the morning of the procedure. Use the Hibiclens wash if available.

·DO NOT shave the area yourself.

·DO NOT use lotions or powders on the area.

The day of surgery:

·Arrive at the hospital at least 1 hour before your scheduled surgery time.

·INFORMED CONSENT: The surgeon will ask you to sign a consent document which verifies that you understand there are risks to every procedure, including but not limited to bleeding, infection, need for re-operation, and site-specific risks which were detailed for you in your pre-operative consultation. Do not sign this document until all your questions are answered and you feel completely comfortable.

·STERILE PREP: The area will be prepped with chloraprep, a lasting sterile prep solution, unless you have a known allergy. It is orange in color and will come off over a period of days after the surgery. In certain cases, we will use a betadine prep, an iodine based solution, which is brown and washes off easily after surgery.

·ANESTHESIA: The type of anesthesia used depends on the operation. You will have a chance to meet your anesthesiologist and discuss your options and preferences.

·The alternatives, risks and benefits of the operation will be discussed during the pre-operative consultation and you will see the surgeon on the day of surgery so that you may ask any last minute questions.

·YOUR SURGICAL WOUNDS:    In most cases, the wound is closed with absorbable sutures under the skin’s surface.

After your operation:

Pain control:

o If you are admitted to the hospital, your nurse will bring your pain medication as instructed.

o If you have been sent home after surgery, you may take Tylenol, motrin, advil, aleve, other NSAID unless instructed otherwise.

o If these over the counter medicines are insufficient, you may take a prescribed narcotic, such as Vicodin or Percocet. Your surgeon will provide this prescription for you.

o Please note that Vicodin and Percocet contain Tylenol; do not take additional Tylenol as an overdose can cause liver toxicity.  

o Vicodin and Percocet cause constipation – take Colace (stool softener) if you are taking any of these narcotic pain medications. Do not wait until you are constipated to start taking the stool softener.

·You may take all your home medications unless otherwise instructed.  Please inform your surgeon if you are on any blood thinners such as Plavix, Xarelto, Coumadin or other anti-platelet agent or anticoagulant.

·For wounds that have been closed and dressed with a clear plastic dressing: You may shower the day of surgery with the dressing on.

o In 48 hours you should take the dressing off. Under the dressing you may see steri-strips (little tapes that take the tension off the wound).  The sutures are under the skin and are absorbable.

o In rare cases, patients may have staples, black or blue sutures holding the wound together, then these sutures will have to be removed at your follow up visit in 5-7 days.

o Regardless of the type of closure, after 48 hours, you may get the wound wet in the shower.


For all patients after operation:

·You should not soak in the baths, Jacuzzi or other hot tub until the wound is fully healed. This usually takes several weeks to a month.

·You should not play contact sports that could cause trauma to the wound for several weeks after your procedure.

·You should not lift, push or pull more than 10 lbs with the extremity on which the procedure was done.

·If you have had abdominal surgery (surgery on your belly), you should not lift, push or pull more than 10 lbs for 6 weeks to allow the wound to heal and minimize the risk of hernia formation.

·You should not use any creams, lotions, poultices, salves, or antibiotic ointment on the wound unless otherwise instructed by the surgeon.

·Your surgeon may provide you with other “dos” and “don’ts” specific to your operation.

IMPORTANT:

CALL YOUR SURGEON IMMEDIATELY OR COME  IN TO BE SEEN AT OUR CLINIC, AMBULATORY CARE, OR THE EMERGENCY ROOM IF YOU HAVE ANY OF THESE SYMPTOMS:

FEVERS OR CHILLS

NAUSEA AND/OR VOMITING

DIARRHEA

CONSTIPATION FOR MORE THAN 3 DAYS

REDNESS OF THE WOUND

DRAINAGE FROM THE WOUND

INCREASING PAIN OR YOU HAVE ANY CONCERNS

MORE SPECIFIC INSTRUCTIONS WILL BE GIVEN TO YOU AT THE TIME OF YOUR CONSULTATION AND AGAIN WHEN YOU ARE DISCHARGED FROM THE HOSPITAL.  THESE INSTRUCTIONS WILL PERTAIN TO YOUR PARTICULAR CASE AND OPERATION. 
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