Preoperative Care
Preoperative tests such as a blood test, urinalysis, and possibly an EKG may be performed a few days before the scheduled surgery, depending on the patient's health.
Some medications must be discontinued prior to the operation, such as drugs that "thin" the blood (e.g., Coumadin®, aspirin), and others must be withheld the day of surgery. This must be discussed with the physician as soon as the decision to operate is made.
Since the fundoplication is performed under general anesthesia, no food or liquid (including water and hard candy) may be consumed after midnight the night before surgery. This restriction reduces the risk of vomiting during or immediately after surgery.
Patients usually check in to the hospital the day before or the day of surgery. Patients must sign an informed consent form, which states that the procedure has been explained to them, they are aware of the risks, and that they know they will be receiving general anesthesia and possibly other medications.
The doctor who administers the anesthesia (i.e., anesthesiologist) speaks to the patient prior to surgery and performs a brief physical assessment. The anesthesiologist must be aware of all medications that are being taken, any allergies, and any prior adverse reaction to anesthesia. This information helps the anesthesiologist select the most suitable anesthetic agents and dosages and avoid possible complications.
The patient is then taken to the preoperative or holding area and must remain in bed, except to use the bathroom. An intravenous is started for fluids and medication, if the patient does not already have one. Sedation is given through the intravenous or by injection to induce drowsiness. Anesthesia is administered in the operating room.
Postoperative Care After surgery, the patient is taken to the postanesthesia care unit (PACU) until the anesthesia wears off and is closely monitored by the nursing staff.
Upon awakening from anesthesia, the patient is groggy, still has the intravenous line in place, and experiences pain in the upper abdomen. They may also be nauseated from the anesthesia and this can be relieved with medication. The intravenous line remains in until fluids taken by mouth are tolerated. Ice chips are offered first in the PACU, then water.
Generally, a patient who has undergone the laparoscopic procedure can drink and eat sooner. A patient who has undergone open surgery may not be able to drink until the next morning. From the PACU, the patient is taken to their hospital room to continue recovery until they are discharged from the hospital.
Patients who have undergone the laparoscopic procedure recover faster and experience less pain at the incision site. Sometimes the pain can be relieved with an over-the-counter remedy, such as Tylenol®. The average hospital stay is 2 to 3 days, but many patients go home the next day.
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