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The Day of Surgery:

(1) Northwick Park Hospital:

On the day of surgery you will arrive in the Day Surgery Unit (adults) or in Jack’s place (children). You may also have been admitted the night before on one of the wards if your operation or past medical history warrants it. There is a small car park just outside the Day Surgery Unit (Pay and Display) but if this is full, there is another car park (Car Park 2, Pay and Display) also beside it. Both car parks are close to the Day Surgery Unit and Jack’s Place.

When you arrive, the receptionist will welcome you and complete your registration details. The nurses will then prepare you for surgery. They will take your pulse and blood pressure and with your help, complete a pre-operative medical information form.

NURSING STATION AT OUR DAY CARE CENTRE

You will be asked to remove all clothing for surgery. This includes your socks, underwear, dentures, glasses, contacts, hair pins or clips, and jewellery. You are not allowed to keep any pierced jewellry on during surgery. We suggest that you do not bring these to the hospital; please also do not bring any valuables or items that you don't want to lose. In place of your clothing , you will be given a theatre gown to wear that opens in the back. Children will have some anaesthetic cream (EMLA) placed on the back of the hands, so they cannot feel the injection needle being inserted.

An anaesthetist will interview you to ensure you are fit for surgery. You will also talk to your surgeons again. Consequently, you will have a chance to ask any questions you might have. The surgeons will explain the procedure to you and will obtain your consent if this has not already been done. 

Your family will be allowed to wait with you until you are due to go to the operating theatre. In the case of children, one parent will be allowed to enter the anaesthetic room with the child but will be asked to leave when the child has been anaesthetised. 

When you go into the anaesthetic/ operating room, your family can wait in the main waiting room on level 2 or go off to the canteen till the operation is over. Waiting for someone in surgery makes for a long day. It has been our experience that children do not do well with this wait. If possible, please find someone to watch them at home.

The length of time you are in surgery and recovery depends on the procedure you are having, the type of anaesthesia, and your physical response to both. However, everyone is required to stay at least one hour after surgery in the recovery room. Your surgeons may be able to give you an estimated length of your stay time when they talk to you pre-operatively.

Once you are in the anaesthetic room, your anaesthetist will place heart monitor pads on your chest, a blood pressure cuff on your arm, and an oxygen saturation probe on your finger. None of these hurts. If the operation involves a general anaesthetic, an intravenous drip will be placed in your arm and you will be induced to sleep by means of both anaesthetic gases (via a face mask) and anaesthetics passed into your veins.

In the recovery room, nurses will continue to monitor your vital signs. Most patients do not have much pain after surgery. If you do have pain, simply tell the nurses caring for you and they will give you medication to make you more comfortable. Visitors are not normally permitted in the recovery room. This is because there will be many patients being cared for in a small area and we must respect everyone's privacy. Exceptions may be made depending on the circumstances or if the patient is a child. Otherwise your family can see you once you are settled in your room. If you are going home after surgery (day case) you will spend your recovery in the Day care unit itself and your visitors will be able to see you once you are awake enough to sit in a chair.

Anyone undergoing general anesthesia may experience a sore throat after surgery. This is due to a tube that the anesthesiologist introduces to your windpipe during surgery. This tube is for your protection to control breathing during surgery. It is very important that you don't have anything in your stomach when this tube is being placed . That is why we ask you not to eat or drink anything after midnight the night before you surgery. The only exception is your routine medication which may be taken, at the usual times, with a sip of water.

We hope this has answered some of your questions and alleviated anxiety. Our goal is to make your road to surgery and recovery as easy as possible. If you have any further questions, the nursing staff and surgeons will be glad to answer them on the day.


The Day Of Surgery:

(2) ACAD (CENTRAL MIDDLESEX HOSPITAL)

FOYER OF THE ACAD CENTRE

On the day of surgery you will arrive at the ACAD centre. When you arrive, the receptionist will welcome you and complete your registration details. You will be directed the pre-operative area (Area 6, Level 1) where the nurses will then prepare you for surgery. They will take your pulse and blood pressure and also go through your medical history.

You will be asked to remove all clothing for surgery. This includes your socks, underwear, dentures, glasses, contacts, hair pins or clips, and jewellery. You are not allowed to keep any pierced jewellry on during surgery. We suggest that you do not bring these to the hospital; please also do not bring any valuables or items that you don't want to lose. In place of your clothing, you will be given a theatre gown to wear that opens in the back. Children will have some anaesthetic cream (EMLA) placed on the back of the hands, so they cannot feel the injection needle being inserted.

An anaesthetist will interview you to ensure you are fit for surgery. You will also talk to your surgeons again. Consequently, you will have a chance to ask any questions you might have. The surgeons will explain the procedure to you and will obtain your consent if this has not already been done. 

In the meantime your family will be asked to wait for you in the main reception area. In the case of children, one parent will be allowed to enter the anaesthetic room with the child but will be asked to leave when the child has been anaesthetised. 

The length of time you are in surgery and recovery depends on the procedure you are having, the type of anaesthesia you choose, and your physical response to both. However, everyone is required to stay at least one hour after surgery in the recovery room. Your surgeons may be able to give you an estimated length of your stay time when they talk to you pre-operatively.

Once you are in the anaesthetic room, your anaesthetist will place heart monitor pads on your chest, a blood pressure cuff on your arm, and an oxygen saturation probe on your finger. None of these hurts. If the operation involves a general anaesthetic, an intravenous drip will be placed in your arm and you will be induced to sleep by means of both anaesthetic gases (via a face mask) and anaesthetics passed into your veins.

Immediately after surgery all patients will first recuperate in the recovery area. In the recovery room, nurses will continue to monitor your vital signs. Most patients do not have much pain after surgery. If you do have pain, simply tell the nurses caring for you and they will give you medication to make you more comfortable. Visitors are not normally permitted in the recovery room. This is because there will be many patients being cared for in a small area and we must respect everyone's privacy. Exceptions may be made depending on the circumstances or if the patient is a child. 

Once you are more stable you will be transferred to different areas depending on whether you are a Day Case or not. 
If you are a Day Case, you will be transferred first to:
(1) the Second Stage Recovery Area where you can eat and drink something. This allows you to recover more fully and allow us to further observe you. Thereafter you will be moved to the Discharge Area where your relatives will be allowed to see you and you will be given instructions and taken home medications before your discharge.

If you are not a Day Case (i.e an inpatient) you will be transferred first to:
(2) the Stepdown ward where you will recover more fully and your relatives will be able to see you. Thereafter you will be moved to the main wards.

Anyone undergoing general anaesthesia may experience a sore throat after surgery. This is due to a tube that the anaesthesiologist introduces to your windpipe during surgery. This tube is for your protection to control breathing during surgery. It is very important that you don't have anything in your stomach when this tube is being placed . That is why we ask you not to eat or drink anything after midnight the night before you surgery. The only exception is your routine medication which may be taken, at the usual times, with a sip of water.

We hope this has answered some of your questions and alleviated anxiety. Our goal is to make your road to surgery and recovery as easy as possible. If you have any further questions, the nursing staff and surgeons will be glad to answer them on the day.

Mr Mingyann Lim MRCS