Having surgery

Surgery can be done in a doctor's office, clinic or hospital operating room. You may be treated as an outpatient (you will not have to stay overnight) or you may have to stay in the hospital for one or more days. It depends on the type of surgery you have, the type of anesthetic used and your overall health.

Your surgeon or healthcare team will talk to you about:

• what happens before surgery and how to prepare for surgery
• what will happen during surgery
• what to expect after surgery and what sort of follow-up will be needed

They will also talk to you about any side effects, or complications, that can happen after your surgery. They will explain all the risks and benefits of the surgery to you and then have you sign a consent form.

The following tasks are done before surgery. Some are done days or weeks before. Others are done right before you go into the operating room.

Some people may not be able to have surgery, for example, if they have certain health problems, including lung, heart, liver or kidney disease. Before you have surgery, your doctor will take a personal health history and do a physical exam. Your doctor will usually do tests to make sure you are healthy enough to have the operation and to help plan the surgery. The following tests are often done before surgery:

• A urinalysis is done to check that the kidneys are working properly.
• Blood tests are done to find out your blood type and to check your blood cell counts, how well your blood clots and how well your liver and kidneys are working.
• A chest x-ray and an electrocardiogram (ECG) are done to check the lungs and heart.
• Other imaging tests, such as an ultrasound, a CT scan or an MRI, are done to find out the size and location of tumours and to see if cancer has spread to nearby organs or lymph nodes.

What you need to do before surgery depends on the type of surgery being done. Most people will need to do the following.

You will need to take a shower the night before surgery or morning of surgery. You may be asked to shave the area being treated to make sure that hair doesn't get into the area (site) of the surgery.

Avoid eating or drinking after midnight the night before surgery, unless you are told otherwise.

Be sure to let your doctor know what medicines you usually take. Do not take your regular medicines unless your healthcare team tells you it is safe to do so.

You may need to take special medicines before surgery. For example, you may need to take a laxative or have an enema to ensure your intestine is empty before some types of bowel or pelvic surgery. Your healthcare team will tell you which medicines to take, as well as how and when to take them.

The anesthesiologist (a doctor who specializes in giving anesthetics) will explain the type of anesthetic you will have during the surgery.

Surgeries are done under totally clean (sterile) conditions, usually in an operating room. Before the surgeon begins, the area being operated on is specially cleaned. You will be given an anesthetic so you don't feel pain and to help you keep still during surgery. The type of anesthetic you receive depends on the type of surgery and your general health. Find of more about anesthesia.

The surgeon often uses a sharp tool to make a cut (incision) in the skin to reach the area or organ to be treated. In some cases, the surgeon can use a natural opening in the body (such as the mouth) to reach a tumour or area being treated.

The surgeon removes tissues, organs or structures. The tumour or cancerous tissue along with a margin of healthy tissue around it is removed. The surgeon may also remove the lymph nodes closest to the tumour. Surgery may also be used to collect a biopsy sample.

Reconstructive surgery to fix or rebuild damaged areas may be done at the same time as surgery to remove a tumour. It can also be done later during another surgery.

If a cut was made during surgery, the surgeon will use stitches or staples to close it. A bandage is placed over the site of the surgery.

Recovery and observation after an operation are important parts of surgery. Your healthcare team monitors you in different ways right after surgery, as you recover in the hospital and after you are sent home.

Right after your surgery is done, you are moved to a recovery area. The healthcare team will monitor you in this area until the anesthetic wears off. They will regularly check your blood pressure, heart rate and breathing. They will also check for signs of bleeding or any other side effects of surgery.

If needed, you are given medicines to control pain, nausea or other symptoms. Your bandages are checked and changed as needed.

Once the healthcare team can tell that you don't have any serious problems or side effects from surgery and that you do not need to be monitored closely, they move you from the recovery area to another room. Depending on the type of surgery you had and your overall health, you may have to be followed during a longer recovery period.

During surgery a tube (called a catheter) may have been placed in the bladder to drain urine (pee). This tube is usually removed when you can urinate on your own. Sometimes tubes (called drains) are placed into or close to the cut made during surgery. These tubes drain extra fluid from the surgical cut. They are removed when there is little fluid coming out of them. They are usually removed a few days after surgery.

During surgery, the healthcare team often places an intravenous (IV) line into a vein. They use this line to replace fluids lost during surgery. Once you can take in fluids and medicines on your own by mouth (orally) and the line is no longer needed, the healthcare team will remove it.

You might not feel like eating or drinking after surgery. Or you may have to wait until your intestine starts working properly. It may take a while to return to a regular diet. Some people may need extra nutrition as a result of surgery or if your diet was poor before the surgery.

The healthcare team may encourage you to take deep breaths and cough regularly to remove mucus and prevent lung infections.

You will need to slowly return to physical activity, but most people are encouraged to get out of bed and start walking very soon after surgery. This helps keep blood clots from forming in the legs, prevents pneumonia and gets the digestive tract moving.

You will be released, or discharged, from the hospital and sent home after you recover from surgery. You may feel tired and weak for a time after the operation. Talk to your healthcare team if you or your caregiver needs help after surgery. They can arrange help for you at home.

A follow-up appointment with the surgeon is usually scheduled to:

• see how you are recovering from surgery
• discuss any test results
• check how the surgical cut is healing and take out stitches or staples
• discuss further treatment options, if needed