Outpatient Surgery

Outpatient surgery means that the patient can go home the same day as surgery, or with a hospital stay of less than 24 hours. Many advances in surgery techniques, such as the use of arthroscopes (flexible tubes, inserted in an incision near a joint), have greatly reduced the length of procedures, the amount of anesthesia (sedative) required, and the length of recovery. For these reasons, patients can be safely discharged from the hospital the same day as surgery. Outpatient procedures are just as safe and effective as ones where you are admitted to the hospital. Most patients who have outpatient surgery are very satisfied with the treatment they receive. Once your caregiver has made a diagnosis, and you have been advised to have an outpatient procedure, someone will discuss with you why an outpatient procedure may be best for you. Some of the reasons may include:

  • Shorter recovery time.

  • Less emotional strain.

  • Ability to sleep at home, in a familiar place, without be woken up by nurses.

  • An outpatient facility (or the doctor's office) often feels more relaxed than a hospital.

  • Outpatient procedures are often more convenient for you and your family.

  • By not staying in the hospital, your cost is generally lower.

TYPE OF FACILITY

There are many types of outpatient facilities, including:

  • Attached to a hospital.

  • Freestanding facility.

  • In the surgeon's office.

PREOPERATIVE EXAMINATION

Before your procedure, you will be given a preoperative visit. This will include a relevant physical exam, review of the exiting condition, review of your medical and surgery history, and any other relevant information (allergies, use of medicines).

PREOPERATIVE TESTS

  • The needed tests will depend on your condition, the operation planned, your medical history, medicine use, and age.

  • Often, no laboratory tests are needed at all.

  • Common tests may include evaluation of blood and urine, an electrocardiogram (ECG) to study the electrical activity of the heart, and a chest radiograph (X-ray) to evaluate your lungs. Other tests may be taken as needed.

PREOPERATIVE PREPARATION

  • Eating and drinking (including coffee) is not allowed for 8 hours before surgery. Food and drinks make general anesthesia more hazardous.

  • Smoking should be reduced or stopped before surgery. This reduces the chance of problems from general anesthesia after surgery. Stopping or reducing smoking after surgery will help healing.

  • If you need to take medicines regularly, be sure to ask the surgeon or anesthesiologist what you should do about this on the day of surgery.

  • Shower or bathe as usual on the day of surgery, unless instructed otherwise.

  • If anything prevents you from keeping your surgery appointment (cough, cold, fever), inform your surgeon and the outpatient surgery facility promptly.

  • Wear loose-fitting clothing.

  • Leave all jewelry and valuables at home.

  • You must have a responsible person take you home, if you have sedation or general anesthesia. It is suggested that you have someone stay with you for the first 24 hours after surgery.

  • Do not forget to bring any regular medicines with you.

REGISTERING AT THE OUTPATIENT FACILITY

  • Make sure you have all the needed laboratory tests that were done to prepare for surgery. If the results are not available, the operation may be postponed.

  • Bring along any insurance information (including insurance card).

  • You will receive an identification band to place on your wrist.

  • You will be shown where to change into the proper gown, cap and slippers. You will then be helped onto a comfortable gurney (rolling bed).

  • The surgeon will ask you, on which side the surgery is to be performed. A mark may be placed on the area by the nurse.

  • You may be given medicine to make you feel drowsy, before you are brought to the operating room.

PROCEDURE

  • When you enter the operating room, there may be a lot of activity going on to prepare the room. This is normal and should not make you nervous.

  • To help you breathe during your procedure, an oxygen mask or small tube (nasal canula) may be placed on your face or at your nose.

  • The anesthesiologist, nurse anesthetist, or surgeon will discuss with you beforehand the type of anesthesia to be used. This can be any of the following:

  • Local Anesthesia: Only the surgical site will be numb.

  • Local Anesthesia with Sedation: Only the surgical site will be numb. However, you will also be given medicine to make you drowsy and to calm your anxiety.

  • General Anesthesia: You are totally asleep.

  • Nerve Block or Regional Anesthesia: The nerve running to the part of your body to be operated on is injected with an anesthetic to make it numb.

  • Spinal Anesthesia: An injection is given into the back, to numb both legs.

  • The nurse will introduce herself or himself and be at your side while you are prepared for surgery.

  • Once an IV needle is placed in your arm, fluids may be started.

  • The surgeon or nurse will rub the surgical site with an antiseptic to clean the area. Then the area will be covered with sterile drapes.

  • If the operation is done with the help of a video screen (arthroscopy), the lights in the room may be dimmed.

  • Wires attached to recording machines will be taped to several places on your skin. They keep track of your blood pressure, heartbeat, breathing, and the level of oxygen in your blood.

  • If local anesthesia is used, you may feel some tugging during the operation, but no pain. If you do feel any twinge of pain, mention it to the surgeon, because this can easily be taken care of.

  • Many patients who have anesthesia along with sedation do not remember much about the operation afterward.

AFTER THE PROCEDURE

  • After your procedure, you will be taken to the recovery room and observed. Do not be alarmed if you wake up in a different room from where you fell asleep. When your blood pressure, pulse, and breathing are normal and you are completely alert, you will be offered some fluids to drink. At this point you can go home with a responsible adult.

  • As needed, you will be given instructions on your diet, activity, wound care, medicines, and follow-up visit.

HOME CARE INSTRUCTIONS

  • Follow the instructions given to you.

  • Do not use power equipment or drive, if you are taking medicines (such as narcotics) that may decrease your alertness, or if you cannot move freely and without pain.

  • Do not take pain medicines on an empty stomach. They might cause nausea.

SEEK MEDICAL CARE IF:

  • Any of the following occur after surgery:

  • You experience pain, numbness, or coldness in the affected limb.

  • Blue, gray, or dark color appears in the fingers or toenails.

  • You develop increased pain, swelling, redness, drainage of fluids, or bleeding in the affected area, despite rest, ice, elevation, and pain medicines.

  • You develop any unusual signs or symptoms.

  • You have chest pains or breathing problems.

  • You have several episodes of vomiting, over a 4 hour period.

  • You have signs of infection, including fever 102° F (38.9° C) or greater.

  • You have any questions.