Sphincterotomy Preoperative Procedures
Most fissure repairs are same day surgeries, meaning that the patient can go home the same day. If a patient needs to remain in the hospital, they are usually discharged the following day.
Preoperative tests including blood and urine tests, a chest x-ray, and an EKG may be performed. Additional tests depend on the patient's health and if general anesthesia is going to be utilized. These tests are normally done a few days prior to surgery.
Medications that "thin" the blood, including aspirin, are usually discontinued several days before a scheduled surgery. On the day of surgery, other prescription drugs may also be withheld. Discontinuing medications must be discussed with the physician before the operation.
If general anesthesia is going to be used, nothing can be eaten from midnight the evening before surgery until after the procedure. This includes all food, water, chewing gum, and candy. This precaution decreases the possibility of vomiting during and after surgery.
For local and spinal anesthesia, dietary restrictions vary. Some doctors require their patients to follow the guidelines for general anesthesia, regardless of the type of anesthesia to be used, because it may be necessary to switch to a general anesthetic during the procedure. Dietary restrictions should be discussed with the physician in advance.
Check-in is usually the same day as the surgery. An informed consent form must be signed acknowledging that the patient understands the procedure, the potential risks, and that they will receive certain medications.
The anesthesiologist (doctor who administers the anesthesia) performs a brief physical examination and takes a patient history. The anesthesiologist must be aware of all medication that the patient is taking, any allergies, and if there has been a prior adverse reaction to anesthesia. This information helps the anesthesiologist select the most suitable anesthetic agents and dosages and avoid possible complications.
Hospitals usually have an area reserved for same day or ambulatory surgical patients. Instead of checking into a room, patients go to this unit before and after the procedure. In preparation for surgery, patients have an intravenous line put in to receive fluids and medication during and after surgery. They may be given a sedative by injection or through the intravenous to help them relax.
Same day surgical patients are taken from this area to the operating room or to the preoperative or holding area, for a short time. Sometimes the intravenous is started here, depending on hospital protocol. The anesthesia is administered in the operating room.