Dr. It will guide you in preparing for total abdominal hysterectomy and other gynecological surgeries performed by Derman Başaran and her team. In addition, the “General Gynecological Post-Surgery Guide” will help you understand what you may encounter during your recovery.
Read this guide at least once before gynecological surgery and use it as a reference in the days leading up to surgery. Bring this guide with you every time you come to our practice, including the day of surgery. You and your companion will refer to this guide throughout your care.
It is important to choose a person to be a companion. He or she will learn about your surgery with you and help with your care as you recover from surgery.
Table of Contents
What is Total Abdominal Hysterectomy?
In this surgical procedure, your doctor will make an incision (surgical incision) in your abdomen (belly). He will remove your uterus and cervix through the incision and close the incision with stitches. Your surgeon may also perform the procedures listed below. These will be done at the same time as your hysterectomy. Salpingo-Oopherectomy
Depending on your surgery, one or both of your ovaries and fallopian tubes may be removed. This is called a salpingo-oophorectomy. If both ovaries are removed, you will enter menopause if you have not yet experienced it. If you are in menopause or have already had it, you will not notice any changes. If you haven't started menopause, you may experience common symptoms such as night sweats, hot flashes, and vaginal dryness. Talk to your doctor about ways to manage these symptoms. Sentinel Lymph Node Mapping and Lymph Node Dissection
Lymph nodes are small, bean-like structures found all over your body. These produce and store cells that help fight infections. Sentinel lymph nodes are the lymph nodes most likely to be affected if you have cancer and it has spread. If your surgeon suspects that you may have cancer, they may do sentinel lymph node mapping and remove some of your lymph nodes, called a lymph node dissection. Before these procedures, you will receive anesthesia (medicines to put you to sleep).
For sentinel lymph node mapping, your surgeon will inject a small amount of dye into the area where the cancer may be. Your surgeon will discuss with you the type of dye they will use. This dye goes to the sentry nodes and turns them blue or green. After the sentinel node(s) are in place, your surgeon will make a small incision. In this process, they will take sentinel nodes (nodes that turn blue or green) and examine them to see if the nodes contain cancer cells. Colon Resection
Colon resection is an operation to remove a cancerous mass. The healthy ends of your colon are then stitched back together. Your surgeon will explain which part of your colon will be removed.
Consumption of Various Products in the Pre-Gynecological Process
The information in this section will help you prepare before gynecological surgery . Read this section when your surgery is planned and refer to this guide as your surgery date approaches.
Alcohol Use in the Process Leading to the Surgery
The amount of alcohol you drink during and after the surgery may affect you. It's important to talk to your healthcare professionals about how much alcohol you drink. This will help us plan your care.
- It is important to choose a person to be a companion. He or she will learn about your surgery with you and help with your care as you recover from surgery.
- If you drink alcohol regularly, you may be at risk for further complications during and after surgery. These include bleeding, infections, heart problems and longer hospital stays.
What You Can Do to Prevent These Problems Before Gynecological Surgery:
- Be honest with your healthcare provider about how much alcohol you drink.
- Try to stop drinking alcohol when your surgery is scheduled. Tell your healthcare provider right away if you develop headaches, nausea, increased anxiety, or are unable to sleep after you stop drinking. These are early signs of alcohol withdrawal and can be treated.
- Tell your healthcare provider if you cannot stop drinking.
- Ask us your questions about alcohol consumption and surgery. As always, all your medical information will be kept confidential.
Notification of Conditions That May Create Risk During the Operation Process
Even if you're not sure, help us keep you safe during your surgery by letting us know if any of the following statements apply to you. If you are using any of the products listed below or if you are experiencing the conditions mentioned, put a tick next to it and inform your doctor.
- I'm taking blood thinners. E.g; aspirin, heparin, warfarin (Coumadin®), clopidogrel (Plavix®), enoxaparin (Lovenox®), dabigatran (Pradaxa®), apixaban (Eliquis®), and rivaroxaban (Xarelto®). Make sure your doctor knows all the medicines you are taking.
- I take prescription (doctor-prescribed) medications, including patches and creams.
- I take over-the-counter medications, including patches and creams.
- I take dietary supplements such as herbs, vitamins, minerals, and natural or home remedies.
- I have a pacemaker, automatic implantable cardioverter defibrillator (AICD), or other cardiac device.
- I have sleep apnea.
- I've had trouble with anesthesia in the past.
- I am allergic to certain medications or materials, including latex.
- I don't want to receive a blood transfusion.
- I drink alcohol.
- I'm smoking.
- I use recreational drugs.
What is Sleep Apnea? What Kind of Effect Does It Have on the Surgery?
Sleep apnea is a common breathing disorder that causes a person to stop breathing for short periods while sleeping. The most common type is obstructive sleep apnea (OSA). With OSA, the airway is completely blocked during sleep. It can cause serious problems during and after surgery. Please tell us if you have or think you may have sleep apnea. If you use a breathing machine (such as CPAP) for sleep apnea, bring it with you on the day of surgery.
Consumption of Various Products in the Pre-Gynecological Process
Pre-Surgical Test (PST)
Before gynecological surgery, you will be given an appointment to undergo pre-operative tests (PST). You can also take your usual medications on the day of your PST appointment. During your appointment, you will meet with a nurse practitioner who works with the anesthesiology staff (doctors and specialist nurses who will give you medication to put you to sleep during your surgery). The GP will review your medical and surgical history with you.
You'll have an electrocardiogram (ECG), chest X-ray, blood tests to check your heart rhythm, and other tests needed to plan your care. Your GP will talk to you about what medications you should take the morning of the surgery.
It is helpful to bring the following with you to your PST appointment:
- A list of all the medicines you take, including patches and creams.
- Results of previous tests, if any, such as a heart stress test, echocardiogram, or carotid doppler study.
Fill in the Companion Form
Identifying a companion will be helpful in the pre- and post-operative period. Specify a person to be reached in case of not being able to contact you. After obtaining the consent of this person, please inform us the name of the accompanying person.
Practice Breathing and Coughing Exercises
Practice deep breathing and coughing before gynecological surgery . You will be given an incentive spirometer to help you expand your lungs. Exercise!
Try to do aerobic exercises such as walking, swimming or cycling at least 1.5 kilometers every day. If it's cold outside, take the stairs in your home or go to a mall or shopping market. Exercise will help your body become the best for your surgery and will make your recovery faster and easier. Start a Healthy Diet
Before the operation, you should have a balanced and healthy diet. If you need help with your diet, talk to your doctor or nurse about consulting a dietitian. Buy 4 Percent Chlorhexidine Gluconate (CHG) Solution Antiseptic Skin Cleanser (such as Hibiclens)
A 4 percent CHG solution is a skin cleanser that kills germs for 24 hours after use. Showering with this solution before surgery will help reduce your risk of post-operative infection. You can purchase an antiseptic skin cleanser with a 4 percent CHG solution from your pharmacy without a prescription, or it can be provided to you by your clinic.
Prepare Your Intestines for Surgery If Necessary!
Your surgeon may want you to clean your bowels before surgery. Your nurse will tell you how it is. GOLYTELY bowel preparation will cause you to experience frequent bowel movements (frequent diarrhea). You will need to purchase the following materials from your pharmacy for your bowel preparation. You don't need a prescription.
- Mix all 1 (227 grams) sachet of polyethylene glycol (GOLYTELY ®) with 2 1.5 liter bottles of clear liquid until GOLYTELY powder is dissolved. After GOLYTELY has thawed, you can put the mixture in the refrigerator if you wish.
- Start drinking the GOLYTELY bowel preparation at 5 pm the day before your surgery. Drink 1 glass of the mixture every 15 minutes until both bottles are empty.
- After you have finished drinking the GOLYTELY bowel preparation, drink 4 to 6 glasses of clear liquid. You can continue to drink clear liquids until midnight or at bedtime, but there is no need.
- Apply Vaseline or A&D ointment to the skin around the anus after each bowel movement. This helps prevent irritation.
7 Days Left for My Surgery!
If you take aspirin or a medicine containing aspirin, you may need to change your dose or stop taking it 7 days before your surgery. Because aspirin can cause bleeding. Follow your healthcare professional's instructions. Stop taking vitamin E, multivitamins, herbal remedies and other nutritional supplements 7 days before your surgery. These, like aspirin, can cause bleeding. What can I do 2 days before the operation?
Stop taking non-steroidal anti-inflammatory drugs (NSAIDs) during this period. You should stop taking NSAIDs such as ibuprofen and naproxen 2 days before your surgery. These drugs can cause bleeding. Acetaminophen is generally safe during your cancer treatment. It doesn't affect platelets, so it doesn't increase your chances of bleeding. But if you're receiving chemotherapy, talk to your healthcare provider before taking acetaminophen. 1 Day Before Your Surgery
A member of our team will call you the day before your surgery. So you can learn when you need to come to the hospital for your surgery.
Skin Cleaning Before Gynecological Surgery
The night before your surgery, take a shower using an antiseptic skin cleanser with 4 percent chlorhexidine gluconate solution as follows;
- Use your regular shampoo to wash your hair. Rinse your head thoroughly.
- Use your regular soap to wash your face and genital area. Rinse your body thoroughly with warm water.
- Open the 4 percent CHG solution bottle. Pour some on your hand or a clean washcloth.
- Move away from the shower drain. Gently rub the 4 percent CHG solution all over your body from your neck to your feet. Do not apply to your face or genitals.
- Return to the shower to rinse off the 4% CHG solution. Use warm water.
- Dry yourself with a clean towel after showering.
- Do not apply any lotion, cream, deodorant, make-up, powder, perfume or cologne after showering.
You May Need to Follow a Clear Liquid Diet
You may need to follow a clear liquid diet the day before your surgery. Your doctor or nurse will give you detailed information about this diet. While following this diet;
- Do not eat solid foods.
- Try to drink at least 1 glass of clear liquid every hour while awake.
- For different types of clear liquids.
- If you are not diabetic, do not drink sugar-free liquids.
I am Diabetic. What will I do?
If you have diabetes, ask the healthcare professional managing your diabetes what you should do when following a clear liquid diet.
- If you are taking insulin or any other medication for diabetes, ask if you need to change the dose.
- Ask if you should drink clear liquids without sugar. Be sure to check your blood sugar levels frequently while following a clear liquid diet. If you have any questions, talk to your healthcare professional.
What can I consume and what should I not consume?
- Do not eat dried food items or products containing spices.
- Do not consume hard candies.
- You can consume fruit juices (like lemonade, apple, cranberry, and grape juices), soda, sports drinks, black coffee, tea, water, but avoid pulpy juices, nectars, milk or cream. Also, do not drink alcoholic beverages.
What will I do on the morning of the surgery?
- Before going to the hospital on the day of surgery, shower with an antiseptic skin cleanser with a 4 percent CHG solution. Use as you did the night before. Do not apply lotion, cream, deodorant, make-up, powder, perfume or cologne after showering.
- If your doctor or nurse has instructed you to take certain medications the morning of your surgery, just take them with a sip of water.
- Do not drink anything, including water, starting 2 hours before arriving at the hospital!
- Do not use any metal items. Remove all jewelry, including body piercings. If the equipment used during your surgery comes into contact with metal, it may cause burns.
- Leave valuables at home, such as credit cards, jewelry or your checkbook.
- Do not eat anything after midnight the night before your surgery. This includes hard candy and gum.
- You will need to remove your glasses, hearing aids, dentures, prosthetic devices, wig, and religious items before being taken into the operating room. You can bring a bag to put them in.
- Wear something comfortable and loose.
- If you usually wear contact lenses, wear your glasses instead.
- On the day of the surgery, you can only bring enough money for the taxi, transportation vehicles or parking fee.
- If available, you may bring your incentive spirometer and/or breathing machine (such as CPAP) for your sleep apnea.
Final Preparations Before Gynecological Surgery
When it's time to go into surgery, you'll receive a hospital gown, bathrobe, and non-slip socks for you to wear.
You will meet with your nurse before the operation. Tell your nurse about the dose of medicines you take after midnight and when you take them. Your nurse may place an intravenous (IV) line in one of your veins, usually in your arm or hand. If your nurse does not insert an IV, your anesthesiologist will do so later when you enter the operating room.
Meet Your Anesthesiologist
Your anesthesiologist, pre-operatively;
- Will review your medical history with you,
- He will talk to you about your comfort and safety during your surgery,
- He will tell you about the anesthesia you will receive.
Prepare for Surgery
After your nurse sees you, one or two visitors may accompany you while you wait for your surgery to begin. When it is time for the surgery, your visitor / visitors will be taken to the waiting area.
You will either walk to the operating room or be taken on a stretcher. A member of the operating room team will help you lie down on the operating bed. Compression boots can be placed on your lower legs. These gently inflate and deflate to aid circulation in your legs. A blood pressure cuff and EKG pads may also be attached to monitor you during surgery.
Once you are comfortable, your anesthesiologist will give you anesthesia and you will sleep. You will also receive fluids through your intravenous line during and after your surgery.
When you are fully asleep, a breathing tube will be placed through your mouth into your windpipe to help you breathe. A urinary catheter may also be inserted to drain urine from your bladder.
When your surgery is finished, your incisions will be closed and dressed. Your breathing tube is usually removed while in the operating room.