Preparing for Your Surgery
The following provides information about the events leading up to your operation as well as what to expect during your stay at Mount Sinai Hospital.
Prior to your surgery, your surgeon's secretary will call you with an appointment to attend the Pre-Admission Unit. The pre-admission visit could take up to four hours to complete.
Please make sure you bring your health card (OHIP card), all of your present medications, a list of previous/present illnesses or surgeries, and any other documents that your doctor has given you. If you do not have a Mount Sinai Hospital card, you will need to get one just before your appointment. Please go to the Admitting Department near the Murray Street entrance of the Hospital for your card.
The purpose of the pre-admission visit is to collect all of your medical and nursing information so that we can provide you with the best possible care during your stay with us. You will meet with a registered nurse, a member of your surgical team, and members of the multidisciplinary team that will look after you before, during and after your surgery.
The registered nurse will take a nursing history and provide you with information about your surgery and what to expect before, during and after your operation. The nurse will take a blood sample and arrange for any other tests that your doctor may have requested. The nurse will give you instructions on how to prepare your bowel and the diet you must follow the day before your surgery. You will also receive information about the day of surgery including the time and place.
A member of the surgical team (your surgeon works with a team of doctors - all in various phases of their education) will take a medical history and complete a medical exam. You will be asked information about your past/present medical problems, previous surgeries, medication history, and family medical history.
You will also have an opportunity to meet members of the interdisciplinary team who will look after you before, during and after your hospital stay. The team consists of:
The pre-admission nurse will consult with any of the team members depending upon your needs and requests. If your surgery involves an ostomy, you will be seen by the Enterostomal Therapy Nurse (ET) who will provide you with support and education as well as mark the site for the ostomy. The involvement of the ET nurse will continue both during and following your hospital stay.
Stoma Site Marking
Ideally, an Enterostomal Therapy Nurse should see you prior to surgery so that an appropriate site can be found on your abdomen for the stoma. The following is considered when selecting the site for an ostomy:
- within the rectus muscle: the rectus muscle runs longitudinally along either side of the abdomen; the stoma should be brought through this muscle in order to provide it with support
- on a flat surface: the ideal pouching surface is flat, so obvious dips and creases on the skin surface are to be avoided
- within the visual field: being able to see the stoma is crucial for self-care, so it should be placed where it can be seen easily (e.g. on top of a large abdominal fold rather than underneath)
- away from belt lines: belts/waist-bands should not be directly on top of a stoma, as these can damage the stoma without your awareness. The stoma should be above or below the belt-line.
- in women, placement below the belt-line is usually easily achieved as skirts and pants tend to be worn high, along the natural waist-line. In men, placement below the belt-line is often problematic, if not impossible as pants are worn significantly lower. Unless adjustments are made to the height at which pants are worn, placement of the stoma often ends up being above the belt-line in men.
The Day of Surgery
At the scheduled time and day of your operation, please go to the Admitting Department (near the Murray Street entrance of the Hospital). The clerk in the department will prepare the information for your chart, provide you with a hospital bracelet and assign you your unit and bed. From the Admitting Department you will go to your assigned unit.
Once on the unit, a registered nurse will greet you and settle you into your room. You will change into a hospital gown making sure all makeup, and nail polish is removed. Please leave all jewelry at home. Your nurse will take your vital signs, start an intravenous and administer any medication that your surgeon may have ordered. Shortly after, a hospital assistant will take you down to the operating room area on the 5th floor on a stretcher.
The Operating Room
You will have a short stay in the waiting area of the operating room where you will meet with your surgical nurse, surgeon and anaesthetist. They may ask you routine questions to clarify the information in your chart.
Once they move you into the operating room, you are settled on the operating table. The operating room is similar to how it is portrayed on any television medical show. The room is bright, somewhat cold and everyone with you in the room is gowned, gloved and masked. Once you are settled, the anaesthetist will quickly put you to sleep with medication in the intravenous.
The Recovery Room or Post Anaesthetic Care Unit (PACU)
Following your operation you will be moved to the PACU, which is on the same floor as the operating room. Your stay in this unit is generally half of the operating time. There will be a nurse at your side checking your vital signs and encouraging you to take deep breaths and move your arms and legs. The intent is to wake you up from the anaesthetic, encourage deep breathing to expand your lungs and promote arm and leg movement to facilitate blood circulation to prevent potential postoperative problems. You may or may not have memories of this stay. Once you are awake, you will be moved to the surgical unit.
The Surgical Unit
Recovery on the surgical unit will vary depending on the type of surgery you had and your rate of recovery. Generally speaking, bowel surgery involves a seven to 10 day hospital stay. The ultimate goal of your post-operative stay is to start the recovery process and regain your strength and energy to enable you to return home.
As much as possible, we try to have one nurse assigned to your care. It is important that you set goals with your nurse and health care team, and share any concerns or questions you may have so that we can provide you with the best possible care. Closer to discharge, the team will discuss plans for your return home and organize home care if is needed.
We encourage all of our patients to leave the hospital by 8:30 a.m. on the day of discharge. This allows us to prepare the room for the next patient. The surgical team will tell you in advance of the date that you will be sent home.
The health care team is happy to respond to questions or concerns from both you and your family. Your comments about your care are always encouraged and welcomed.
- do not bring valuables to the Hospital
- do bring a Walkman, reading material
- do bring slippers, housecoat and toiletries
- do encourage family/friends to visit - visiting hours
- allow for four to six weeks for recovery following surgery
- do not lift or do any strenuous activity for six weeks
- a surgical waiting area (near the Murray Street entrance) is available for family/friends to wait during your surgery
If you have any questions about this information or your surgery, please contact your surgeon's secretary.