The timeline of surgical planning

Assoc. Prof. Didem Öncel Yakar

The timeline of surgical planning

When surgical treatment is recommended for any reason, patients or their relatives may experience fear of surgery. Delaying treatment is never recommended. Delay in treatment might lead to ongoing complaints/problems related to the disease, progression in some cases, and the risk of developing severe complications. For all these reasons, once the need for surgical treatment is indicated, it is beneficial not to delay surgery.

Having knowledge about the surgical processes has a relaxing effect on patients. Of course, each surgery has different preparation algorithms, but the standard steps can be listed as follows:

1) Correct diagnosis-correct treatment: The physician diagnoses the patient by completing the necessary differential diagnosis steps according to the patient’s complaints, physical examination, laboratory and imaging results. Today, patients often apply to surgeons to consult a treatment option, after a diagnosis has already been reached together with the results of previous examinations. Current guidelines clearly indicate which medical and surgical treatment should be recommended for each pathology. Patients in this group may proceed to the second stage in planning. For patients whose treatment option is not clear, the most appropriate treatment is determined through a second opinion consult or multi-disciplinary councils attended by more than one expert.

2) Evaluation process before surgical treatment: Which type of anesthesia will be used for this procedure for a patient who needs surgery, whether there are accompanying medical conditions that increase the risk of the patient due to both surgery and anesthesia (heart disease, drug allergy, use of anticoagulants, etc.) are questioned in detail. All necessary pre-operative examinations are provided. After these stages are completed, the patient is evaluated by the Anesthesiologist. If there are any preliminary preparation steps required due to anesthesia risks, they are completed.

3) Surgical planning: After the appropriate diagnosis and treatment selection, the patient, whose pre-operative evaluation processes are completed, is planned for the surgery date and time.

4) Preparations on the day before the operation: The medical preparations of the patients must be completed on the day before the operation, all necessary surgical-medical materials/products must be prepared, and if Private Health Insurance is used, the pre-approval of hospitalization must be obtained. Since the patient will not be able to take a bath on the first day after the operation, it is recommended to bathe today and sleep as regularly as possible. It is preferred that smoking be stopped at least one week prior to surgery.

5) Preparations on the day of surgery: Unless otherwise stated, the patients must restrain from food or liquids 6 (six) hours before the surgery. It is one of the most common mistakes to accept this period as a period of time in which nothing is eaten but can be drunk. This process is managed differently in groups with diabetes.

6) After hospitalization: The patient is requested to be hospitalized at least 1-1.5 hours before the planned operation time. During this period, the patient is placed in his/her room, evaluated by his nurse, seen by the surgeon, and transferred to the operating room after obtaining medical consent forms. The patient, who is observed in the recovery room at the end of the operation, is taken to his/her room after the necessary controls are completed.

7) Postoperative in-hospital period: After the regular follow-up and treatment of the patient who is transferred from the operating room to the ward, daily functions such as mobilization and oral intake are allowed with the approval of the surgical team. Post-surgical care and hospitalization process differ for each surgery. After the appropriate process is completed without any problems, the patient is discharged home in good health for outpatient follow-up.

8) Post-operative recovery period: During the discharge from the hospital, all necessary daily recommendations to the patient, the drugs to be used, what to pay attention to, and when to apply to the hospital are explained in detail. An appointment is made for routine outpatient control. Patients who complete this process without any problems usually return to their normal lives within the estimated time specified for them.