Typically GYN surgery involves a hysterectomy whether it is a total abdominal (TAH), total vaginal (TVH) or laproscopic-assisted hysterectomy (LAVH). A hysterectomy is the surgical removal of the uterus through an abdominal incision or through the vagina. A hysterectomy may also include removal of the fallopian tubes and ovaries. Discuss with your physician which is the appropriate surgery for you. The TAH requires a bikini line incision, the TVH is executed through the vagina and the LAVH requires several tiny incisions.

Before, During and After will give you an idea of what to plan for prior to going to surgery. Keep in mind that everyone's experience may be different.

Before
Prior to surgery you will receive a call from the Roper St. Francis Healthcare Pre-Admission Nurse to discuss lab work, specific orders from your physician, fasting prior to surgery, medications and time to report to the hospital admissions office. The following are other items to put on your checklist.

Pre-Surgery Checklist

• Prior to surgery you will have your lab work done according to what your physician ordered.
• You will need to take an enema and douche the night before surgery.
• You will need to fast after midnight the night before surgery.
• You will need to fast after midnight the night before surgery.
• Report to the hospital promptly at your appointment time.
• Bring any medication that you routinely take.

Packing

• Bring the following: toothbrush and toothpaste, deodorant, shampoo, pillow, gowns, robe and slippers, socks, cases for glasses or contacts.
• Do not bring jewelry, money, credit cards or other valuables.

At the Hospital

• Leave your suitcase in the car until you are assigned a room.
• Bring your parking garage ticket with you to admissions.
• After you are admitted, your family will go to a waiting room and you will be escorted to a pre-surgical admission area.

During

Preparation for surgery

• Prior to surgery you will be visited by your physician and meet your anesthesiologist.
• You will need to sign a release or consent, if you have not already completed one.
• Your IV will be started and you will be given instructions on the PCA pump and Pain Scale.
• Your family will be allowed to visit after surgery preparation is complete.

During Surgery

• Your family will wait in the waiting room and calls may be made to them periodically during your surgery to update them on your condition.

After

Recovery Room

• You will continue to have monitoring and other medical equipment such as IVs, monitors and oxygen attached to you during recovery.
• Recovery Room staff will keep you warm with blankets.
• Expect to hear beeps from monitors and to be frequently asked your name and where you are.
• Pain meds will be administered in your IV/PCA, and will be measured by a pain scale chart.
• Your family will be notified when surgery is over and when you are placed in your room.
• Your physician will usually visit your family after surgery.

In Your Room

• You will be transferred to your room when the Recovery Room staff considers your condition stable.
• You will be asked to take deep breathes and change your position in the bed frequently.
• We will attempt to help you make yourself as comfortable as possible, though you will probably experience some discomfort. It may help to use a pillow to support your abdomen when turning, coughing and when getting up.
• The nursing staff will elevate the head of bed and assist you in sitting up.
• Nursing will check your temperature, pulse and blood pressure frequently.
• You will be allowed ice chips at first and then clear liquids will follow.
• You will be asked to perform leg exercises to promote circulation.
• Pain and nausea medications will be administered as soon as possible upon request.

Day After Surgery

• Your IV and foley will be removed at this time.
• You will be encouraged to take short walks with assistance, each walk becoming a little longer.
• Your liquid diet may progress to solid food.
• It is important to tell your nurse when you go to the bathroom and are able to release gas.
• Expect small amounts of vaginal bleeding. Peri pads are available, you may bring panty liners if you prefer.
• Your nurse will assist with your bathing needs.
• When in the shower, keep the water temperature on the cool side to prevent weakness/dizziness.
• Your nurse will perform incision care.
• You can expect some gas or back discomfort and/or constipation.

Going Home

• Your caregiver will instruct you and give you information on how to "Take Care of Yourself."
• When your physician releases you, inform your nurse that you are ready to leave the hospital, Escort staff will bring a cart and a wheelchair and will assist you out of the hospital.
• After you are home, you will receive a phone call to see how you are recovering. We continuously strive for excellence in patient care and welcome your input.

Instructions Following GYN Surgery
Returning home is the most important part of your recovery. This is your time--gradually regain your strength and learn to care for yourself. The following are general guidelines. Specific instructions will be given by your physician.

Nutrition

• Eat a well balanced diet to help your body heal.
• Choose low-fat dairy products, lean meats, fruits and vegetables, whole grain breads and cereals.
• Drink plenty of fluids (6-8 glasses a day), unless you have been told to limit fluids for other conditions.

Medications

• Take your medicine exactly as instructed. If taking pain medication, take with food and do not drink alcohol or engage in activities that require mental alertness.
• A mild laxative may be helpful, however, check with your physician.

Activities

• Rest is important.pace yourself. Increase activities gradually.
• Avoid heavy lifting.
• Climbing stairs should be done slowly and with care. Avoid excessive trips up and down.
• Your physician will discuss when you can resume sexual activity.

Special Care
Shower as usual. If you have an incision, pat dry with a clean towel. No lotions, powders or oils should be used on your incision.

Signs to Report
Call your physician if you have any of the following symptoms:

• Heavy, bright red bleeding or passing clots.
• Pain or burning when you urinate.
• Fever of 101 or greater.
• Foul discharge or drainage from your vagina.
• Difficulty with bowel movements.
• Redness or swelling at the incision site.
• Pain not relieved by prescribed medications.
• Any problems or significant changes