Iowa Health Book: Surgery

Ambulatory Surgery

University of Iowa Department of Surgery
Peer Review Status: None

Ambulatory Surgery Center
University of Iowa Hospitals and Clinics
Iowa City, Iowa, 52242

What is Ambulatory Surgery?

Advances in medicine, anesthesia, and technology have made surgical procedures faster and less complicated. Because of this, many of today's procedures , when performed on healthy patients, no longer require an overnight stay in the hospital. Doctors, hospitals, and health care advisory groups recognize and agree that this is a safe and efficient way to provide quality health care. Ambulatory surgery is a practical alternative for many people having elective surgery.

Advantages for You

The concept of surgery with little or no hospitalization has met with success because of its advantages.

• Safe and efficient way to provide care
• Convenience
• Less time away from your family
• Less time away from work or school
• You can recover at home in familiar surroundings
• More involvement of your family before surgery and after initial recovery
• Less expensive for you and your insurance company

Ambulatory Surgery Center

The University of Iowa Hospitals and Clinics offers an ambulatory surgery facility for patients. The center is located on the 5th floor of the Colloton Pavilion. All perioperative care of the patient is accomplished in this area, including the pre-operative evaluation, surgery, and recovery. In most cases patients will come directly to the center and be discharged from here after ceratin criteria are met. Involvement of families is recognized as important and is highly encouraged.

Preparing for Surgery

Preparation for surgery involves more than physical preparation, such as physical exam or lab tests. It means preparing yourself mentally, having the confidence and attitude that can help your operation go more smoothly. Your confidence will come in part from your understanding of what happens before, during and after surgery.

Ambulatory surgery is a team effort. YOU are the most important member of the team. Successful surgery requires your help. Before surgery you will have discussions with a nurse, your surgeon, and your anesthesiologist. It is important for you to:

• Ask questions
• Answer questions honestly and completely
• Tell us about any concerns you have about surgery
• Follow all instructions
• Be on time for all appointments

All members of the health care team are here to provide you and your family with physical and emotional support, answer any questions, and assist with making your ambulatory surgical experience the best it can be.

General Information

A nurse from the Ambulatory Surgery Center will attempt to call you the afternoon before surgery, unless you will be seen in our hospital on this day. You will receive information about the time your surgery is scheduled and your pre-operative instructions will be reviewed. You will also have an opportunity to ask any last minute questions.

There is no day care at the University of Iowa Hospitals. Children under 12 are not allowed in the recovery areas.

Please call if you have any change in your health, such as a cold, flu, temperature, or if you need to cancel surgery for any other reason. This is also the number to call if you have additional questions about your surgery.

Pre-Operative Instructions

• You should not eat or drink anything after midnight unless otherwise instructed by a physician.
• Shower with soap and brush your teeth the morning of surgery. Taking a shower helps to remove the normal bacteria on your skin that may cause an infection.
• Remove all nail polish and makeup.
• Leave all jewelry, money, watches, and other valuables at home. You may not wear any jewelry to surgery. The hospital cannot be responsible for valuables brought with you.
• Wear comfortable, casual, clothing that is easy to get on and off. The hospital will provide you with a gown, robe, and slippers. Please do not bring these items with you. There will be a locker available for your clothing while you are in surgery.
• You may bring reading materials, knitting, etc. to enjoy during the waiting period. Parents may want to bring a favorite toy for their child/infant. Please label these clearly with the child's name.
• Take routine medications only as directed by your surgeon or anesthesiologist. Bring a list of these medications and the dosage with you.

Before you come to the hospital, please make arrangements for an adult friend or relative to accompany you. This person must be able to accompany you the day of surgery and be able to drive you home when you are discharged. You will not be allowed to leave the Ambulatory Surgery Center alone following administration of anesthetic, pain, or relaxation medications.

It is very important that these instructions be followed carefully since you or your child's safety depends on it. Failure to follow these instructions may result in surgery being cancelled.

Day of Surgery

When you arrive at the hospital, go directly to the Ambulatory Surgery Center unless otherwise directed. Enter through the main hospital entrance, proceed through the lobby and Carver Pavilion to the Colloton Pavilion. Take elevator "H" to the 5th floor. There is an information desk in the main lobby of the hospital if you need assistance.

When you arrive in the Center, the nursing staff will assist you.

• You will be asked to undress and put on a hospital gown, robe, and slippers.
• Your pulse, temperature, blood pressure, and weight will be obtained by the nurse and he/she will do a brief interview.
• Your surgeon will review your medical history and physical to determine that you are ready for surgery. You will meet with your anesthesiologist , who will briefly interview you, discuss type of anesthesia, and check lab studies.
• You will be taken to the operating room when preparations are completed.
• Your family may accompany you as far as the exam room. Parents may be allowed to accompany their child until he/she is asleep. Please let the nurse know if you would like to do this so that you can change into the correct clothing.

During Surgery

While you are in surgery, your family can wait in the Ambulatory Surgery Center reception area.

Immediately before surgery adults may have an IV inserted. Medications and fluids are given through the IV.

After Surgery

When surgery is completed, you will be taken to the recovery area until you are capable of being released. If you have had a general or spinal anesthetic you will go to 1st Stage Recovery for a minimum of one hour, and then proceed to the 2nd Stage Recovery Area in most cases. Your family will be allowed to visit you in the 2nd stage recovery area.

It is impossible to predict exactly how long you will be in the Recovery area. The length of time varies from person to person and is determined by the length and type of surgical procedure, the type of anesthetic drugs used, and individual patient differences.

While you are in the recovery area, the nurses will be monitoring your progress and assisting with your recovery.

• The nurse will check your pulse, temperature, and blood pressure periodically.
• You may have medication for pain or nausea if needed.
• After you are in the 2nd Stage Recovery Area, you will be asked to stand and walk. You may feel tired and dizzy, but the nurse will be there to assist you.
• You will be given ice chips and then liquids to drink. Your IV will be removed when you are able to keep fluids down.

You will be evaluated by a physician and a nurse prior to discharge to determine that you are ready to leave the Center.

Discharge instructions will be given to you and the adult accompanying you before you leave. Any newly prescribed medications will be obtained for you from our pharmacy if you wish.

On rare occasions you may be kept in the hospital longer than anticipated. If for any reason you are not well enough to go home, you will be admitted to the hospital. If your doctor and anesthesiologist believe additional observation is required, you will be moved to a patient room.

Discharge Instruction

Even though you are awake more quickly after ambulatory surgery, and patients do not usually experience any difficulty, you may feel drowsy for 24-48 hours after surgery. Your coordination may also be affected.

For your safety:

• Do not drive a car or operate hazardous machinery.
• Do not drink alcohol.
• Do not take any medication unless prescribed by your physician.

Important decisions should be delayed until you have made a complete recovery.

You should plan to go home immediately from the recovery area and rest for the remainder of the day with a responsible adult to assist you.

Remember, you must have a responsible adult to accompany you home from the hospital.

Please refer to the other instructional materials you were given for complete information specific to your surgery.

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Last Modified: December 02, 1996