Surgery, is an important method of treatment for patient diseases. Surgery as method is continuously evolving since centuries and continues to be heavily dependent on the individual who is operating. Surgery is an ‘art’ form with science deciding how this art is executed. Like any art, it is learnt by apprenticeship, skill improved through rigorous practice but success( the outcome) is dependant less on the creativity (unlike other arts) and more on the scientific temper of the individual.

Why do we use it?

It is a long established fact that certain diseases that are not amenable to medical treatment are to be managed by removing the organ that is diseased. If expendable, it is removed in toto,  else an attempt to repair the organ of interest is done. Improvements in science is allowing us to be less aggressive with the momentum to repair rather than excise (remove) taking an upper hand.

What do i need to ask my doctor before surgery ?

1.INDICATION (for surgery)

Treatment for diseases can be a single modality or a combination. For example, appendicitis in early stages can be managed by medicines but in advanced stages patient cannot be saved without a surgical excision of the infected appendix.  So speak to your surgeon, explore all the options for treatment available and confirm for yourself that surgery is the best option available in the context of the disease and the general condition of the patient.

2. Pros & Cons

Every surgery has pros and cons. Every surgery has some element of risk. Every surgery will have side effects / unintended or undesired changes. It is our necessity to find out about these and be mentally prepared. The above are a necessary evil and when we are aware and mentally prepare ourselves the degree of unhappiness and unpleasantness can be decreased.

Remember the saying ” No Pain No Gain!” 

Make a conscious effort, to enquire and understand the possible issues. For Eg., a hysterectomy done through the vagina can lead to pelvic floor weakness while when done abdominal route can lead to abdominal wall weakness (hernia). So the choice is to be made in the context of the individual desires and disease condition. An awareness about unavoidable side effects can be managed by modifying our lifestyle, eating habits or exercise as required!

3. Risk of Surgery

Risk for any surgery can be classified into anaesthesia risk and surgical risk. 

Anaesthesia drugs have an effect on the various organs of the body and thus can manifest in the form of delay in recovering from anaesthesia, need for post operative ventilator support or need for Intensive Care unit (ICU) admission. A rough estimate of the probability for the above is made by the anaesthetist  in the PAC done before admission into the hospital (Based on Surgical Profile).

The second type of risk to be aware of is the Pure Surgical risk. This risk is due to the actual surgery like injury to other organs, risk of bleeding during surgery or infection in the post operative period. Also be aware of long term problems like hernia or functional changes that happen several weeks to years later. These vary from surgery to surgery.

Be aware, a surgeon can vouch and counsel  for the surgical risk and it is your responsibility to check with anaesthetist for the other types of risks.

4. Duration of Hospital Stay.

An idea about duration of the stay in the hospital (most of the time the estimate is approximate)  will help us plan for leave at our jobs, making arrangements at home, planning children school arrangements and sometimes  for hiring help at home. 

5. Pain of Surgery

The moment we are told about the need for surgery, the first thing that comes to our mind is the fear of pain. So, make every attempt to asses the extent of the pain you might experience, how long the pain will be there, and how to manage pain. 

Present day analgesics ( pain killers) are extremely potent and safe and hence can be taken even at home under the supervision of a doctor.

A discussion of possible pain, and an awareness that your physician understands your pain requirements will give you tremendous psychological relief  and better prepares you for the surgery.

6. Food & diet.

If pain is the first thought  that comes to our mind, when told about surgery, the second most important thought is about food and how long we need to miss our favourite food (or is it Biryani!)

Most non intestinal surgeries allow us to have food  by evening or maximum the next day. Unfortunately, it is the surgeries on the intestine that need significant period of fasting. After most such surgeries, our intestines would be resting and hence we would not feel the hunger for the first 2-3 days. Infact, the surgeon would be quite happy to know the moment you start feeling hunger, as it is a sure sign of recovery!


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