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Patient Education

Prepare for Robotic Surgery

It’s important to read and understand your post-operative instructions prior to your surgery. Our goal is for you to understand what to expect. Plan to have a family member or friend stay with you for a few days to help you during the immediate recovery. Please follow all pre-operative instructions exactly. It may involve urine or blood test, a chest x-ray, electrocardiogram (EKG), or an ultrasound or CT scan. Your doctor will communicate with you about any medical or cardiac clearance needed from your primary care physician or cardiologist. It’s important we know your heart and lungs are safe for surgery.

1 Month Before Surgery

  • Start or increase your exercise. This helps prepare your heart and lungs for surgery and helps with recovery. The goal is 30 minutes of cardiovascular exercise three to five times a week.
  • Quit smoking. If your surgery is more than a month away, quitting smoking helps improve lung function and the body’s ability to carry oxygen-rich blood to vital organs.
  • Make healthy living a priority. Healthy bodies are more likely to recovery faster after surgery and experience fewer complications. A healthy lifestyle includes eating fruits and vegetables every day and getting regular exercise. It’s also important that diabetes, blood pressure and cholesterol are under control.

7 – 10 Days Before Surgery

  • Stop all blood thinners 7-10 days prior to surgery. This includes aspirin products, ibuprofen (Advil, Alleve, Anacin, Bufferin, Naproxen), clopidogrel (Plavix) and warfarin (Coumadin). If you have serious heart or blood conditions, follow instructions from your cardiologist or primary care physician regarding blood thinner management.
  • Stop all herbal medications and vitamin supplements 10 days before surgery. We do know all the effects of herbal medications on thinning blood or their possible interactions with anesthetics. It’s particularly important to discontinue use of vitamin E supplements.

2 Days Before Surgery

  • Absolutely NO Alcohol or alcoholic beverages 48 hours before and after surgery. They can have disastrous consequences on the surgery as well as the anesthesia.

1 Day Before Surgery

  • Do not eat or drink by mouth after midnight the day before your surgery. This includes any fluids, water, mints, candy, gum, or coffee. The only exception is to take heart or blood pressure medications on the day of surgery with a small sip of water. You may be asked to clean out your bowels a day or two before surgery. A bowel prep may involve a clear liquid diet one to two days before surgery, laxative medications and/or an enema.

Day of Surgery

  • Bring all medications currently prescribed to you in their labeled containers with you to the hospital.
  • Bring your CPAP machine with you if you suffer from sleep apnea.
  • Leave non-essential valuables (such as watches, jewelry, cell phones) at home to reduce the chance of misplacing or losing them in the hospital.
  • If you wear glasses, contact lenses, false teeth or related personal items remember to bring a case to store them in during surgery.

If you have any questions about these instructions, including what you should and should not be taking and any other questions, please contact your surgeon.  Please print these instructions out and keep them handy during the time leading up to your surgery.

 

Post-Surgery Instructions

Most patients experience minimal discomfort after robotic surgery, and we recommend ibuprofen or Tylenol (acetaminophen) for pain first. Stronger prescription pain kills can cause constipation, and it’s best to avoid them if possible. However, if you do experience significant pain with non-prescription pain medicines, contact your physician.

You may resume your normal medications as soon as you’re discharged from the hospital.You may be given a stool softener for constipation when you leave the hospital. We also recommend prune juice or milk of magnesia until you have your first bowel movement. Choose bland foods for the first few days after surgery. Some people prefer a mostly liquid diet. After your first bowel movement, you can increase to soups, scrambled eggs and oatmeal, etc., then back to your normal diet when you’re ready.

You may shower the day of your discharge unless otherwise instructed by your surgeon. The sutures used will dissolve on their own, and don’t need to be removed. A small amount of redness around the incision sites is normal. If you experience clear or bloody drainage that soaks dressings or redness greater than ½ inch around the incision, call your physician.

If you have any questions about these instructions, please call for clarification. These are given in your best interest in preparation for a smooth and complication-free procedure.

Frequently Asked Questions


What is traditional open surgery?

Open surgery involves an incision at the site where the organ or tissue needs to be repaired, treated or removed. The incision itself requires time to heal, and often results in blood loss and a longer hospital stay. After leaving the hospital, recovery usually means six to eight weeks without strenuous activity and a higher risk for surgical site infections.

What is robotic surgery?

Robotic surgery is the most recent and innovate surgical technique. It’s a type of minimally invasive surgery that provides surgeons with enhanced capabilities, including high-definition 3D vision and a magnified view inside the surgical site. Although it’s called a robot, the da Vinci Surgical System can’t act on its own. The surgery is performed entirely by the surgeon who controls the robot as it translates his or her movements into more precise movements of the tiny instruments inside the patient’s body.

A number of procedures that could not be performed using traditional technologies can now be performed using the da Vinci Surgical System, and that number continues to grow. The advanced feature set and extensive EndoWrist instrumentation of the da Vinci Surgical System enable surgeons to perform more procedures through 1–2 centimeter incisions.

What are the benefits of robotic surgery?

There are many potential benefits of robotic surgery. The small incisions required often result in less blood loss, lower risk of blood transfusion and infection, a shorter hospital stay, decreased need for pain medication and a quicker recovery and return to normal function.

Patients also benefit the ten-fold magnification and three-dimensional vision that robotic assisted minimally invasive surgery provides. The robotic arms move with incredible precision, moving in, out and with a wrist-like turning motion of 360 degrees. Human tremor is filtered out completely. The surgeon and surgical team work from a comfortable, ergonomic position, resulting in less fatigue during long complex cases.

Who is on the surgical team for robotic surgery?

The surgeon sits at a specialized control center known has a console where he or she controls the camera, robotic arms and other equipment. An assistant sits at the patient's bedside and uses laparoscopic tools through ports to provide suction, change robotic tools, make adjustments to the robotic arms as needed, and to introduce stitches.

A scrub technician sits on the other side of the patient to provide tools and sutures and to make adjustments to the robotic arms. The anesthesiologist remains at the patient's head, providing anesthesia and monitoring the patient's heart and lungs.

Is robotic surgery covered by insurance?

Robotic surgery is a type of minimally invasive surgery. Any insurance coverage that covers minimally invasive surgery generally covers this type of surgery and is true for widely held insurance plans such as Medicare. Each person’s coverage depends on your individual plan and benefits.

Who is a candidate for robotic surgery?

Every person’s situation and health history is unique, and it’s important to discuss all your options with your surgeon to find the one that’s right for you. For the right patients, robotic surgery provides another option that surgeons and patients can consider when planning effective treatment. Just like the laparoscopic method, there are risks including potential for infection, bleeding and cardiopulmonary risks associated with anesthesia. Regardless of the procedure, patients and doctors need to work together to determine the best approach. It’s also about the team that contributes to each person’s overall healthcare experience.

When someone is faced with a surgery, a surgeon’s role is to provide options. People shouldn’t choose a surgeon or a hospital based only on robotic capabilities, but because of the surgical expertise, the amazing team of professionals and the surgeons who use this and other technologies to provide the best outcomes for our patients.

What are potential complications to robotic surgery?

For any procedure (open or minimally invasive), there are potential risks, including:

  • Temporary pain or discomfort from use of air or gas in the procedure
  • Longer operating time and time under anesthesia
  • The need to transition to an open procedure during surgery.
  • Temporary pain and/or nerve injury associated with positioning.

As with any surgical procedure, it’s important to talk with your doctor to determine if a da Vinci surgery is right for you. Patients and doctors should work together to review all surgical and non-surgical options to make an informed decision.

What is CHI Memorial’s experience with the da Vinci® Surgical System?

CHI Memorial Computer and Robotics Enhanced Surgery Center was the first in the Chattanooga region to offer robotic surgery. And we’re a first to offer the latest technology featuring 3-D vision for superior physician depth perception and visualization. We are committed to offering the most innovative, patient-focused treatments – and that dedication is demonstrated by our continuously highly patient satisfaction scores. Our team of experience surgeons perform more robotic-assisted surgeries than anyone in the community. Our unparalleled expertise creates the best possible surgical experience for you.