How to prepare for surgery

Establishing a diagnosis

If you, your GP or a specialist doctor suspects that you have a condition that can be treated surgically, the first step is to establish the exact diagnosis and therapeutic indication. For this you will need an appointment for a consultation.

At the consultation, you will present yourself with all your previous medical documents and the results of the investigations carried out so far. If we consider that further investigations or tests are necessary, we will indicate them and guide you to have them carried out as soon as possible.

Once the diagnosis is established with certainty, you will be informed about your disease, its natural course and the therapeutic options currently available.

The next step will be to schedule surgery. You will be informed of the date, time, place of admission and the documents required for admission.


How do you prepare before admission?

It is important that on the day of admission (whether you are scheduled for surgery on the same day or not) you present yourself on an empty stomach (not eating, not drinking), as blood samples will be taken which may be influenced by food and fluid intake.

Depending on whether you choose to have surgery in a state or private medical system, you will need certain documents.

If you opt for the state medical system, being insured, you will present the following documents at admission:

  • Identity card
  • Activated health card/ Eurocard
  • Referral note from GP to surgery
  • Proof of insurance status (proof of employment, unemployment certificate, pension voucher)
  • Certificate with the number of days of leave

Depending on the case, we will inform you in advance if additional documents are required.
If admission is requested on request (without a referral note or uninsured), you will pay the cost of the medical services, based on the expense statement issued by the hospital’s secretary/financial service.

According to the health insurance law, all patients residing in Romania benefit from free emergency medical assistance.

So, whether you are insured or not, if your illness is an immediate emergency, you will not have to pay for medical services.

If admission to a private clinic is desired, we will guide you through the steps to be followed on a case-by-case basis.


How do you prepare before surgery?

In the case of surgery, pre-operative preparation is essential to achieve a good outcome and help your healing process.

All recommendations to you will come from your surgeon, and these measures will depend entirely on the type of diagnosis that has been established beforehand. Recommendations include:

  • Food rest
  • Need for chronic medication on the day of surgery
  • The need for personal hygiene
  • Administration of specific medication
  • The need for further medical investigations or procedures

Also, after providing complete and accurate information about your current and previous health status (you will submit all previous medical documents) you will be given information about the proposed surgery along with the risks involved.

If you agree to the surgery, you will sign an informed consent.

Of course, before the operation you will also have a pre-anaesthetic consultation where, depending on your diagnosis, the anaesthesiologist will decide on the type of anaesthesia to be performed (general anaesthesia, regional/rachian anaesthesia, local anaesthesia).


What happens on the day of surgery?

On the day of surgery a shower is mandatory. Please do not use skin creams or lotions. You will shave off your abdominal hair. If you are unable to do this yourself, you will ask a nurse for help. You will receive special clothing to wear during the procedure.

Dentures (such as false teeth), instruments (such as glasses or contact lenses), jewellery, make-up and nail varnish should be removed before going into the operating theatre. If you have a hearing aid, you can keep it.

The nurse will escort you to the OR preparation room. There you will be welcomed by an operating room employee.
Before the operation, you will receive an infusion of anaesthetic. It is also possible that depending on your diagnosis and proposed surgery, a thin tube (epidural catheter) may be fitted to your back. Through this tube you will be given analgesics (painkillers) during and after the procedure.

Depending on your diagnosis, your surgeon will decide the type of surgical approach:
– by classical approach – with incision/cut (as appropriate, this may be in the middle of the abdomen or below the ribs, etc.)
– by minimally invasive (laparoscopic) approach through several small incisions through which working instruments are introduced.

All the aspects related to the most suitable surgical approach for your case and related to the surgery itself (all that it entails) will be explained to you in advance when you will have the discussion with your surgeon at the time of the consultation.


Recovery after surgery

After the operation, depending on the decision of the surgeon and the anaesthetist, you will remain under supervision, either on the surgical ward or in the intensive care unit, where the ATI doctor and the attending surgeon will be responsible for the medical treatment. Also, if you are supervised on the intensive care unit, the ICU doctors will decide when you will return to the surgical ward.

On the surgical ward, the attending surgeon or his/her designee will visit you every day to discuss with you how your recovery is progressing. During these visits new decisions and changes in treatment can be made.

The nurse will help you immediately after the operation in caring for your general physical condition. She/he will encourage you to do increasingly independent activities. In addition, you will receive instructions on special care, if necessary.
Please note that after surgery, depending on the diagnosis, you may have several tubes connected, on a temporary basis:

  • Infusions for administering fluids and medicines

They may be located in a vein in the arm and under the collarbone or in the neck area. As soon as you are able to drink enough fluids and no longer need IV medication, they will be removed.

  • A tube to the nose (nasal mask)

To administer supplemental oxygen if needed.

  • A possible epidural catheter

This is a thin, back-mounted tube through which pain medication is administered. The dose of medication depends on the pain you feel and your recovery. As soon as these painkillers are no longer administered, the catheter will be removed.

  • A possible urinary catheter to drain urine through the urethra

Depending on the case, it may be held in place for a day or more. If you have had bladder surgery, then the urinary catheter may be used for a longer period; it will also be maintained if it is felt that diuretic monitoring is necessary.

  • Drains in the area of the operation to drain excess intra-abdominal fluid

They are gradually removed depending on the amount and appearance of the fluid after a postoperative ultrasound check.

  • Nasogastric tube

It is the tube that reaches into the stomach to drain gastric juice.

  • Catheter for jejunostomy

This being a tube fixed through the small intestine, used for tube feeding if needed.

Depending on the case, a bag ostomy.


Discharge recommendations and how to follow up postoperatively?

– Removal of the tegumentary sutures will be done 7-10 days postoperatively or 12-14 days, depending on your case

– Hygiene and dietary regime, depending on the case

– Avoiding strenuous physical exertion and, depending on the case, if the operation was performed using the classical approach, wearing a non-elastic abdominal support girdle for at least 3-6 months.

– Continuation of treatment for the associated pathology with possible reassessment by the family or specialist doctor

– For patients with malignant pathology/cancer, to have an oncological consultation, presenting the discharge note and the result of the histopathological examination to the oncologist

– For patients with malignant pathology, check-ups are carried out as agreed with the treating surgeon, every 3-6-12 months (or as needed, depending on the case), with subsequent management to be determined by the treating physician.


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