On the day of your cancer surgery
You normally go into hospital on the day of your surgery. Sometimes you may go in the night before. This depends on the hospital.
The ward staff make sure you are ready and prepared for your operation. And your surgeon and anaesthetist will see you before you go to the operating theatre.
Before you leave home
Have a shower before you go to the hospital. This is to lower the chance of you getting an infection. Follow the instructions if the hospital gave you special soap or wipes to use.
You are normally asked not to wear:
- body lotion or face creams
- spray deodorant – you may be able to wear roll on
- hair spray or mousse
- aftershave or perfume
- makeup
- nail varnish – you should remove nail varnish, gel, acrylic or other types of false or long lasting nail varnish before you come to the hospital
- jewellery – you can normally keep a wedding ring on
Some people have carbohydrate drinks to take before their operation. Follow the instructions from pre operative assessment on when to drink them.
When you arrive
If you have been asked to go to the ward, your nurse normally shows you to your bed.
Sometimes you go to the surgical admissions lounge instead of the ward. This is where you get ready for surgery. You go to the operating theatre from the lounge. And you are taken back to a ward after your operation.
A friend or relative can normally accompany you while you settle in. But they may then be asked to leave. Speak to your nurse if you think you need someone to stay with you.
Getting ready
There is a lot to do to make sure you are ready for your operation. Your nurse checks your blood pressure, pulse and breathing rate and asks you to get changed.
What you wear
They normally ask you to wear a:
- hospital identification band – this is usually on your wrist
- theatre gown – they may also ask you to wear paper underwear
- pair of surgical stockings – these are to help prevent blood clots. Your nurse measures your legs to make sure the stockings are the right size. Ask for help if you are unable to put them on yourself
You can normally put your dressing gown and slippers on over the top until you are ready to go for your operation.
Pregnancy test
If you are able to get pregnant, your nurse asks if they can do a pregnancy test. They will give you a pot to do a pee in. And then put the pee into a special machine. It normally takes about 5 minutes to find out the result.
Questions your nurse will ask
Your nurse will go through a checklist to make sure you are ready for surgery. They ask:
- when you last had something to eat and drink
- if you have any allergies
- if you have taken off any jewellery – they may put some surgical tape around your wedding ring to secure it
- if you have any contact lenses in
- if you have any loose or false teeth - you can usually keep false teeth in until you get to the anaesthetic room
Tell your nurse if there is anything else you think they should know.
Preparing the area
Your nurse may ask if they can remove the hair where you are having the surgery. They do this with electric clippers. They remove the hair either on the ward or in the operating theatre after you've had your anaesthetic.
Seeing your surgeon
Your surgeon will come and see you on the ward or lounge before your operation.
They will go through the consent form again with you. This is to check that you still understand about the operation and have no new questions.
Your surgeon may draw on your skin in a marker pen. This is to mark the area where they are going to operate. They do this before the operation so you can see it.
Seeing your anaesthetist
The anaesthetist is the doctor who gives you the anaesthetic. They look after you during the operation. And they arrange medicines for afterwards such as painkillers.
Your anaesthetist will come and see you on the day of your operation. It may not be the same one that you saw at your pre operative assessment. But they will have all the notes from that appointment.
They will ask you about your health again to make sure nothing has changed. And they will explain about the type of anaesthetic you are going to have.
Medicines before your operation
Occasionally, your anaesthetist wants you to have some medicines before your operation. This might be to:
- reduce the amount of acid in your stomach – this can stop you feeling sick
- make you feel relaxed – this is called premed
- relieve pain after the operation
Going for your operation
You have your surgery in a special room called an operating theatre.
The operating theatre staff tell your nurse when they are ready for you to have your operation. Your nurse then does some final checks to make sure you are ready.
Usually, you walk to the operating theatre with your nurse or a member of the theatre staff. But if you have had premed they take you on a trolley.
In the operating theatre
All the doctors and nurses wear clothes like pyjamas (scrubs) and hats. During the operation they wear gowns over their scrubs and a mask. This lowers the risk of you getting an infection.
You might have your anaesthetic in:
- the operating theatre
- a small room called an anaesthetic room – after your anaesthetic the theatre staff take you into the operating theatre
Both rooms have lots of machines and somewhere for you to lay.
Having an anaesthetic
There are different types of anaesthetics. You have them so you can’t feel any pain during the operation.
Before your anaesthetic
The theatre staff may put some stickers on your chest. This is to check your heart. They also normally put a:
- blood pressure cuff on your arm
- a special peg on your finger to measure your oxygen levels
- small tube into a vein in your arm (cannula) so that you can have any fluids and medicines you need during the operation
They may not put all of these on if you are only having a local anaesthetic.
Local anaesthetic
Your anaesthetist or surgeon injects a liquid anaesthetic to numb a small area. This means you are awake during the operation. You shouldn’t feel any pain, but you might feel pressure in the area during surgery.
You may also have sedation to help you relax. This can make you feel sleepy.
Regional anaesthetic
Your anaesthetist numbs a large area or part of your body such as your arm. Or they may put an injection into your back to numb your lower body.
If you just have a regional anaesthetic, you will be awake during the operation. But your anaesthetist may also give you sedation to help you relax and feel sleepy. With a regional anaesthetic, you may feel pressure in the area during surgery. But you shouldn’t feel any pain.
Sometimes your anaesthetist might give you both a regional and general anaesthetic. The regional anaesthetic helps with pain relief after the operation.
Your doctor may suggest a regional anaesthetic if you are not well enough to have a general anaesthetic. Unfortunately, you can’t have a regional anaesthetic for all types of surgery.
A regional anaesthetic into your back can be either:
- a spinal anaesthetic
- an epidural
Spinal anaesthetic
Your anaesthetist injects local anaesthetic between the bones (vertebrae) in your lower back. The anaesthetic goes into the fluid below the spinal cord where the nerves to your lower body are. This is called the subarachnoid space. The anaesthetic makes your lower body feel numb.
Epidural
Your anaesthetist puts a needle between the vertebrae of your back. They then pass a thin hollow tube called a cannula down the needle. The cannula goes into an area called the epidural space. Where in your back they put the epidural cannula depends on which part of your body they want to numb. This might be your chest area (thorax), your tummy (abdomen) or your lower body including your legs.
Your anaesthetist then injects local anaesthetic down the cannula and into the space.
General anaesthetic
Your anaesthetist gives you medicines to make you unconscious. This is so you aren't aware of anything during the operation.
They give you the medicines into the cannula in your vein. This makes you go into a deep sleep. Your anaesthetist looks after your breathing while you are asleep. And they wake you up when the operation is over.