Frequently Asked Questions
Before Surgery
The following are important questions to review with your healthcare provider before surgery.
It is important to remember that a well-informed patient tends to be more satisfied with the outcome or results of a procedure.
An updated medical history and physical form will be required for all patients. Certain individuals may also need to undergo blood tests, an EKG, or x-rays, as advised by the surgeon. The surgeon will inform you about the location where these tests will be conducted.
While it is optional, some patients may opt to visit the Center prior to their scheduled surgery date in order to finalize paperwork or settle payments. It is highly recommended that you complete all necessary preoperative documentation well in advance of the surgery day.
Certainly! It is highly recommended that you complete all registration forms prior to your surgery day. We strongly encourage you to take advantage of our online registration feature for your convenience. By doing so, you can simply walk in on the day of your surgery and be escorted directly to your room, avoiding the need to fill out extensive paperwork.
It is important for your physician to provide a clear explanation of the recommended surgical procedure, outlining the steps involved and offering illustrative examples. Additionally, you should inquire about any alternative methods available for performing the operation and the reasons why your physician prefers one approach over others.
The motivations for undergoing surgery can range from pain relief and prevention to diagnostic purposes and enhancing bodily function. It is important to request a detailed explanation from your physician regarding why this particular procedure is being recommended for you. Ensure that you have a clear understanding of how this surgery can potentially improve your medical condition.
It is crucial for your physician to provide a comprehensive overview of the specific advantages you can expect from undergoing surgery. Additionally, you should inquire about the typical duration of these benefits, as some may only last a short period and could potentially necessitate a second operation, while others may offer lifelong benefits.
Furthermore, it is advisable to discuss with your physician any published information available regarding the outcomes of the recommended procedure. This will enable you to make an informed decision and develop realistic expectations regarding the surgery.
Before undergoing surgery, it is crucial to carefully consider the benefits in relation to the potential risks. Request your physician to provide a comprehensive overview of the potential complications, such as infection and bleeding, as well as any potential side effects that may arise from the procedure. Additionally, it is important to have a conversation about pain management strategies and discuss methods to effectively alleviate any pain that may occur following the procedure.
If, after carefully considering the advantages and disadvantages of the surgery, you make the decision not to proceed with the operation, it is important to understand the potential implications. It is crucial to ascertain whether the condition may deteriorate over time or if there is a possibility that it may resolve on its own.
By selecting a physician who has received comprehensive training and possesses extensive experience in conducting the specific procedure, you can reduce the potential risks associated with surgery. Feel free to inquire about the physician’s familiarity with the procedure, including the frequency at which they have performed it, their track record of successful outcomes, as well as any complications encountered. This information will aid in your decision-making process and instill confidence in your chosen physician.
You can visit this page to learn more about Dr Pankaj Singhal.
The type of anesthesia administered during gynecologic oncology surgery can vary depending on the specific procedure, patient factors, and the recommendation of the anesthesia team. Generally, gynecologic oncology surgeries may involve either general anesthesia or regional anesthesia.
- General anesthesia: This involves administering medications to induce a state of unconsciousness, ensuring that the patient is asleep and unaware during the surgery. It is typically delivered via intravenous (IV) medications and inhaled anesthetics.
- Regional anesthesia: This involves numbing specific regions of the body, such as the lower abdomen or pelvic area, while the patient remains conscious. Common types of regional anesthesia used in gynecologic oncology surgery include epidural anesthesia or spinal anesthesia. These techniques can provide pain relief and minimize the need for general anesthesia.
The choice of anesthesia is made based on the surgical procedure, patient’s medical condition, preferences, and the expertise of the anesthesia team. The anesthesiologist will evaluate the patient prior to surgery and discuss the most suitable anesthesia options and their potential risks and benefits.
Be aware that not all procedure costs may be covered by your health plan, which could leave you responsible for certain expenses. Consult the NYGS Staff regarding the overall cost of the operation and the extent of coverage provided by your insurance or health plan.
Consent and Advanced Directives
Before your surgery, you will be provided with a thorough explanation of the procedure, its intended purpose, associated risks, and the anticipated outcome. It is possible that you will be requested to sign an “informed consent” form, which explicitly acknowledges your understanding of all aspects related to your surgery. It is essential to carefully review the consent form before signing it. If you have any inquiries or require additional information, do not hesitate to ask your physician.
For certain surgeries involving significant risks, hospital staff may advise you to prepare “advance directives.” Advance directives are legal documents that express a patient’s preferences regarding treatment and resuscitation in the event that the patient becomes unable to communicate their wishes. There are two types of advance directives:
- Living Will – This document outlines the patient’s desires regarding the withholding or withdrawal of life support in cases where the patient has an incurable and terminal condition.
- Durable Power of Attorney for Healthcare – This document appoints another individual to make healthcare decisions on behalf of the patient if they become incapable of doing so. This designated person also possesses the authority to make final decisions regarding the discontinuation of treatment.
These advance directives serve to ensure that your wishes regarding medical treatment are respected even if you are unable to advocate for yourself.
For any diagnostic procedure or surgery involving a pre-adolescent child, parental consent is mandatory. However, in the case of “emancipated” adolescents, they have the authority to provide consent for their own medical care. An emancipated adolescent is an individual who meets any of the following criteria:
- Is married
- Attends college away from home
- Has a child
- Is serving in the military
In these specific circumstances, the adolescent has the legal capacity to make decisions regarding their own healthcare without requiring parental consent.
In certain situations, an adult patient may be temporarily or permanently unable to make decisions regarding their medical care. This can occur due to accidental unconsciousness, confusion resulting from advanced age, or severe illness. In such cases, a family member will be approached and entrusted with the responsibility of making any essential medical decisions on behalf of the patient.
The Day of Surgery
During the day of your surgery, you will have the opportunity to meet the medical team responsible for your procedure. This team may consist of your surgeon, the anesthesiologist, and other healthcare professionals involved.
Throughout the duration of your procedure, every member of the surgical team takes special precautions and exercises utmost care to prevent any complications from occurring.
Here are some things you can anticipate:
- You might be required to change into a hospital gown.
- An identification bracelet will be provided to you.
- An intravenous line may be inserted into your forearm to administer anesthesia and other medications.
- You will be transferred to the operating room on a stretcher.
It’s important that you come prepared for your day surgery visit and we will ensure that you are as comfortable as possible during your time on the unit.
Please bring your dressing gown and slippers. A urine sample maybe required on admission and if an infection is detected we may have to delay your surgery. Please ensure you tell our team if you have been feeling unwell prior to your admission because your safety is our priority at all times.
Also please bring a copy of an up to date prescription or your regular medications in their original packaging and do not bring any controlled drugs into the hospital. If you wear contact lenses these will need to be removed for surgery.
Don’t forget to bring any reading material or puzzle books with you and tablets as we have free wifi available via the Cloud. You may have your mobile phone with you but please ensure this is on silent so it doesn’t disturb other patients.
The operating room can appear overwhelming due to its array of unfamiliar technical equipment. Here is a brief description of equipment commonly found in operating rooms, although the specific setup may vary depending on the type of surgery:
- The operating table, located at the center of the room, can be adjusted in height, position, and tilt.
- An operating lamp provides optimal illumination without casting shadows during the surgery.
- You may be connected to various monitors that track vital signs such as heart rate and blood pressure.
- A ventilator or breathing machine is positioned near the head of the operating table, assisting with your breathing by delivering oxygen and regulating airflow in and out of your lungs.
- Sterile instruments necessary for the surgery are arranged on a stainless steel table.
- A diathermy machine, often present, helps control bleeding.
- In certain surgeries, specialized equipment such as a heart-lung machine may be brought into the room.
Please note that the specific equipment in the operating room can vary based on the nature of the surgical procedure.
Here are some of the recent advancements available to patients during or after surgery:
- Bispectral Index (BIS): This innovative monitoring system analyzes a patient’s brain wave pattern to determine the depth of sedation. It allows anesthesiologists to continuously assess the state of the brain in various settings such as the intensive care unit, operating room, and clinical research.
- Scopolamine Patch: Approved by the US Food and Drug Administration (FDA), the scopolamine patch is a prescription drug used to prevent nausea and vomiting associated with motion sickness. It can now be utilized to prevent these symptoms during or after surgery. The patch is placed behind the ear before surgery, allowing medication to be absorbed through the skin and enter the bloodstream directly.
- Remifentanil: This analgesic is used for inducing and maintaining general anesthesia during surgery. It has the unique characteristic of breaking down rapidly in the bloodstream and body tissues. Unlike other drugs, remifentanil is metabolized by enzymes in the blood and muscles, leading to faster awakening and the removal of breathing tubes that are often used during surgery.
- Fibrin Sealants: These sealants, derived from blood plasma, are used to control bleeding from small blood vessels during surgery when conventional techniques are not feasible. Fibrin sealants form a flexible material that covers the oozing blood vessel, aiding in the rapid cessation of bleeding.
These advancements aim to enhance patient care, improve surgical outcomes, and provide more effective treatment options.
After Surgery
After your surgery, it is crucial to discuss the following important questions with your healthcare provider. Being well-informed about your condition and treatment tends to contribute to higher satisfaction with the overall outcome or results of the procedure.
It is important to consult your physician about the anticipated experiences during the initial days following surgery, as well as in the subsequent weeks and months. You should inquire about the expected duration of your hospital stay, any restrictions or limitations that will be imposed on you, and whether there are any specific supplies or equipment you will require upon your discharge. Being well-informed in advance about what to expect will aid in your ability to cope and facilitate a speedier recovery after the surgery.
The physician typically provides a prescription for Percocet or Darvocet (a bit milder) to each patient who is discharged home after surgery. Both of these medications are very effective at “taking the edge off” of post-operative pain, but it is very common to continue experiencing some pain. Both of these medications can be taken one or two tablets at a time as frequently as every 4-6 hours. The physician usually recommends taking at least one before going to bed the first night, even if there is no pain at the moment, since pain can often arise during the night and disturb sleep.
Both of these medicines also have the side effects of nausea, vomiting, constipation, and itching. Having these side effects does not mean the patient is allergic to the medicine, but it does mean they might want to limit their use of them as soon as the decrease in pain permits.
After being discharged from the hospital or surgery center, it is common for patients to observe a slight amount of blood staining on their incisions. Although this may appear concerning, it is usually not a serious issue. Applying gentle pressure to the bleeding site using a sterile 4×4 gauze, which can be obtained from a drugstore, is both acceptable and safe. Firmly applying pressure for approximately 5 minutes will typically halt minor episodes of bleeding. However, if active bleeding persists, please contact us to inform us of the situation.
The majority of incisions are sealed with a product called Dermabond, which functions similarly to superglue. It is safe to wash these incisions in the shower starting from the day after surgery. Allowing water to run over the incision and gently cleansing it with soap and water is considered safe during this period. However, it is advisable to refrain from soaking in a swimming pool or bathtub for a minimum of 5 days after surgery to allow for further healing to take place.
The physician typically recommends eating lightly on the night after surgery. Chicken soup and Ginger Ale are the usual suggestions, although any comparable light fare would suffice. Usually, on the day after surgery, most of the anesthesia medications have been cleared from your system, allowing you to return to your regular diet without difficulty. If you still experience some nausea, it is advised to proceed slowly with small meals and choose lighter foods until the queasy feeling has completely resolved. These symptoms are generally caused by the medications used during anesthesia, and your body will naturally eliminate them over time.
Many patients may observe mild redness around their incisions, and concerns about infection are common. In the case of laparoscopic operations, wound infections are extremely rare. Most infections typically occur between 5 and 10 days after surgery and are characterized by symptoms such as pain, pronounced redness, and the possibility of yellow fluid or pus drainage. Fever of 101 degrees Fahrenheit or higher may also accompany these signs. If you experience these symptoms, it is recommended to visit our office within the next 48 hours. Treatment usually involves taking oral antibiotics, although in some cases, we may need to open a portion of the incision in the office to facilitate fluid drainage.
After being discharged from the hospital, it is normal to experience soreness, but you should be capable of walking independently. It is encouraged to engage in activities and move around as much as you can tolerate. Your energy levels may be lower for approximately a week following the surgery, but don’t hesitate to be as active as possible. For open abdominal surgery or hernia repairs, we generally advise avoiding lifting objects weighing more than 10 pounds for four weeks. However, other procedures such as neck or laparoscopic operations do not have lifting restrictions. Once you have a driver, you are free to leave home and go wherever you please starting from the day after discharge. Additionally, there is no harm in walking up stairs.
The physician prefers to schedule follow-up appointments in the office within 7 to 14 days after most operations. However, there may be exceptions, and the physician will communicate any specific instructions to you as necessary. It’s important to note that these follow-up appointments are not automatically scheduled, so please contact our office at (631) 533-9733 to book your appointment.
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