In the days before surgery:

  1. Stop aspirin and aspirin type products such as Bufferin, Advil and most anti-arthritis medication at least seven (and preferably fourteen) days before surgery. Tylenol is OK. If you are on blood thinners such as Coumadin or Plavix this will need to be discussed with your surgeon and internist and these medications discontinued.
  2. Gently wash the area of proposed surgery with HIBICLENS starting 48 hours ahead of time. Do not shave the area. This will be done on the day of surgery.
  3. Notify us if you have a cough or infection anywhere on your body within seven days of surgery.
  4. Be sure that you complete all tests and any recommended consultations well in advance of surgery.
  5. Eat normally on the night before surgery but take no alcohol after 8PM and nothing to eat or drink after 12 midnight except prescription medications.
  6. Call us if you have any questions about the upcoming surgery.

In the days before surgery:

  1. Have nothing to eat or drink after 12 midnight except for prescription medications you have been told to take with a sip of water.
  2. Leave home with plenty of time to spare as traffic around Piedmont Hospital and in the parking decks can be amazingly congested even before daylight. If your surgery is at Buckhead Ambulatory Surgery Center there will be less traffic.
  3. Follow the instructions you were given about where to report. If you get lost, call a hospital operator by dialing “O” on any hospital telephone.
  4. Once you arrive at the proper place, you will be checked in, your paperwork will be reviewed and about an hour before the scheduled start of the surgery, you will be given injection(s) to help you relax. If your situation calls for them, elastic stockings will be placed on your legs to prevent blood clots later.
  5. You may have an additional Hibiclens wash and your operative site skin may need to be shaved to minimize pain due to hairiness when the dressing is removed after surgery.
  6. After all preparations are completed, you will be dressed in a hospital gown and moved to a stretcher and taken to the preoperative area where an IV will be started and all of the paperwork will be checked again. If you are having an “epidural”, it may be placed in the preoperative area. Next you will be transferred onto a narrower table in the operating room. Before surgery begins, and EKG pad will be placed on your back, a blood pressure cuff will be placed on your arm, usually on the side opposite your IV, and an electrocautery grounding pad will be placed on your leg or thigh to allow us to us an electric needle to stop bleeding during surgery, and a device that looks somewhat like a plastic clothespin will be placed on your finger or thumb nail to monitor the oxygen in your blood. Since Piedmont Hospital is a “teaching hospital”, I will have the advantage of a surgical resident assisting me with your surgery. This will help make your surgery safer and quicker and allows me a chance to pass my experience and knowledge along to others. The resident will introduce him/herself to you before surgery and will often have an opportunity to see you again before you leave the hospital.
  7. The skin in the area of surgery will be sterilized and anesthesia will be initiated either by injection into the epidural catheter taped to your back or by injection of local anesthetic around the area of the hernia, or both.
  8. After checking to be sure that the anesthesia is effective, the incision will be made and the repair carried out, often using mesh or synthetic sutures. After the deep layers of the repair are finished, the skin will be closed with staples or paper tapes and a bandage will be applied.
  9. You will then go to a recovery area until discharge criteria are met, usually several hours later. There are several discharge criteria:

    You must be taking at least liquids by mouth, after which your IV can come out.Your pain must be adequately controlled with oral pain medications. You may need injectable pain medications initially, but switch to oral medications as soon as possible
    You should be ambulating

  10. The nurses at Piedmont Hospital are among the best anywhere, and they will take very good care of you. They have extensive experience in caring for patients who have had hernia surgery and they know what to look for ad how to tell when patients are – are not – able to go home safely. They will contact us if they have any reservations about the appropriateness of your going home. If you are not discharged on the day of surgery, we will check on you early the next morning and probably will be able to discharge you then.
  11. At least 95% of reasonably healthy patients of all ages undergoing umbilical or groin hernia surgery will go home on the day of surgery, and less than 1% will need to return to the hospital – even briefly – for any reason prior to their scheduled office follow-up.
  12. During the several hours following the surgery, you should review the discharge instructions we have given you at least twice. If anything is unclear, check with your nurse right away. If he/she is in doubt also, we will be contacted for clarification. A certain amount of insecurity about going home is common, but there is no need to be uneasy about questions that you haven’t asked or that we haven’t yet answered. When in doubt, ask your nurse; if still in doubt, have the nurse call us. Do not leave until you are sure that you know what you are supposed to do.
  13. At the time of discharge, you should be sure to take with you:

    Discharge instruction sheet (yellow) from the hospital
    Any prescriptions that we have given you.Gauze pads and tape for dressing changes.
    All medications and other personal belongings that you brought with you to the hospital.