Surgery

The day of the surgery

Overview

Before surgery, nurses will make sure you are ready, and an anaesthetist will give you medicine to prevent pain and keep you comfortable.

During surgery, sometimes unexpected changes may mean the surgeon needs to adjust the procedure. After surgery, nurses will check your wound and show you how to care for it at home.

Procedures vary between hospitals and according to whether you have surgery as an inpatient or outpatient.

Surgery booklet (PDF)
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What's on this page

Admission and preparation

The hospital will give you a time to arrive, called the admission time. When you’re admitted, you might not know the exact time of the surgery, but you’ll probably know if it will be in the morning or afternoon. Sometimes there are unexpected delays due to emergencies and the order of the operating list may change – the receptionists and nurses will keep you informed.

Sometimes surgery is cancelled on the day. Whatever the reason, this can be very stressful. The hospital staff will talk to you about the next steps and your ongoing plan of care.

Getting ready

Before you go to the operating theatre, a nurse will:

  • review your medical history and whether you have any allergies
  • check you have had a recent negative rapid antigen test for COVID
  • place an identification band around your wrist or ankle
  • ask when and what you last ate and drank
  • check your temperature, blood pressure, pulse, height, weight and blood oxygen levels
  • confirm the procedure you are having.

You will be directed to a bed and asked to change into a surgical gown. You will be able to change behind a curtain or screen for privacy.

Preventing blood clots

All surgery and some cancers increase the risk of developing blood clots in the deep veins of the legs or pelvis (deep vein thrombosis or DVT). You will usually be given compression stockings to wear on your legs during and after surgery to reduce the risk. Some people may have special cuffs placed around the legs to keep the calf muscles moving during, and sometimes after, surgery. You may also be given an injection of blood-thinning medicine.

Personal possessions

Your clothes and other possessions may be stored under the bed in a bag, in a locker or given to your support person. It’s best to leave valuables at home.

Fall prevention

You may be given non-slip socks to wear while you are in hospital to help prevent you falling over and hurting yourself.

Anaesthetic

A specialist doctor called an anaesthetist will give you drugs to send you to sleep or to numb an area of the body. This is called anaesthesia and it will prevent you feeling pain or discomfort during surgery. The anaesthetist may also give you other drugs to manage pain and nausea.

When you meet your anaesthetist before surgery, it is important to tell them about any medical conditions or drug allergies you have, when you last ate or drank, and if you have had a previous reaction to an anaesthetic (including if you took a long time to wake up).

When I spoke with the anaesthetist before my mastectomy, we talked about which options for controlling pain would be best for me because some pain medicines made me feel sick.

Beth

Different types of anaesthetic

There are different types of anaesthetic used for surgery. The type you have will depend on the procedure you are having and your overall health. You may have more than one type of anaesthetic during surgery.

Light or conscious sedation

You will be given drugs to relax you and make you sleepy. You will still be able to respond to directions from your surgeon but may not remember what happened during the procedure.

Local anaesthetic

This involves numbing the skin or part of the body being operated on. It is usually done as an injection, but drops, sprays or ointments may be used instead. You may also be given a sedative to help you relax. You are still awake during surgery, but you won’t feel any pain or discomfort. The numbness typically lasts for several hours to a day.

Regional anaesthetic (nerve block)

A local anaesthetic is injected through a needle placed close to a nerve or nerves near the surgical site. This numbs the part of the body being operated on. You may be given a light sedative to help you relax, or stronger medicine to put you to sleep.

General anaesthetic

You will be given strong drugs to make you go to sleep (fall unconscious). Both injectable drugs and gases can be used. Some people say that having a general anaesthetic feels like a deep, dreamless sleep. You may experience some side effects, such as nausea and confusion, when you wake up from general anaesthetic. Most of these effects are temporary and are easily managed by your medical team – learn more about side effects.

The operating theatre

You might walk into the operating theatre or lie on a bed that is wheeled into the operating theatre. This is a purpose-designed, very clean room where the surgery occurs. The surgical team will wear caps, masks and gowns to help prevent infection.

The anaesthetist will put a small tube (cannula) into a vein in the back of your hand or arm. The anaesthetic drugs will be injected into the cannula. You might feel a slight stinging sensation, but once the drugs start to work you won’t be aware of what’s happening.

During surgery under general anaesthetic, a machine called a ventilator helps you breathe or may breathe for you. The anaesthetist constantly checks your vital signs (heart rate, temperature, blood pressure and blood oxygen levels) to ensure they remain at normal levels. They also give you pain medicine so you are comfortable when you wake up.

When the surgery is finished, the anaesthetist will stop giving you the anaesthetic drugs and may give you other drugs to reverse the effects of general anaesthesia. You’ll be taken to the recovery room, and your vital signs will be monitored until you are fully awake.

Unknown factors

There are some things the medical team may not know until the surgery is in progress. The surgeon will discuss these with you beforehand.

Taking a different approach

The surgeon may start the operation as keyhole surgery but have to change to open surgery. This is usually so they can more easily reach the tumour or safely deal with any complications that may arise.

Adding another surgeon

Another surgeon may be in the theatre to assist your surgeon. This is standard practice, as the extra support can help achieve the best outcome for you. For example, a gynaecological surgeon may ask a colorectal surgeon to assist if they discover gynaecological cancer extending into the bowel.

Removing extra tissue

It may be difficult for your surgeon to tell you exactly what will be removed during the surgery, as scans don’t always detect all of the cancer. You may be asked to give consent to remove extra tissue if the cancer is found in places not shown on scans.

Creating a stoma

The medical team will talk to you before surgery if they might need to create an artificial opening in the body (stoma). An example of a stoma is a colostomy. This is when part of the large bowel is brought out to the surface of your abdomen through an opening created surgically, and a disposable bag is attached to collect waste matter. A stoma may be temporary or permanent.

Needing a blood transfusion

If you lose a lot of blood during surgery, some blood or blood products can be given to you through a vein (transfusion). Blood from a donor is usually used. There are strict screening and safety measures in place, so transfusion is generally very safe. Let your surgeon know beforehand if you refuse to have a transfusion or you are worried about needing a blood transfusion.

Surgical wound

Your surgeon will close up the wound (incision) created during the surgery. Their approach will depend on the part of your body affected and the kind of surgery you had (e.g. open or keyhole surgery).

Common ways to close a surgical wound include:

  • sutures or stitches – sewing the wound closed using a strong, threadlike material that can dissolve or will be removed at a later date (see Follow-up appointments)
  • staples – small metal clips that will be removed by your doctor once the wound has healed
  • glue – clear liquid or paste that dissolves over time; used to seal minor wounds (up to 5 cm) or applied on top of sutures
  • adhesive strips – pieces of tape placed across the wound to hold the edges together; may be used with sutures.

Wound coverings (dressings)

The wound will usually be covered with a surgical dressing to keep it dry and clean. This may be a waterproof adhesive dressing or a bandage. The dressing will be changed as needed. If you have surgery as an inpatient, the nurses will look at the wound to see if it’s healing and to check for bleeding or signs of infection. When you have a shower, if the dressing is not waterproof it may need to be covered or taken off and reapplied afterwards.

The wound may feel itchy or irritated after surgery. Tell the nurses if this happens – it could be a sign it’s healing, but it may also be a problem, such as an allergic reaction to adhesive tape.

Before you leave hospital, the nurses will give you instructions about how to care for your wound and dressing.

After the wide local excision, the wound looked red and was sore, but this improved.

Pete

Complications during surgery

Sometimes problems or complications occur during surgery. It’s very unlikely that all of the complications described here would apply to you. Your surgeon can give you a better idea of the risks of your operation. Generally, the more complex the surgery is, the higher the chance of problems. Read about some complications after surgery.

Tell your doctor if you’ve had any previous reactions to over-the-counter, prescription or herbal medicine, even if the reaction was small.

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