Laparoscopic Cholecystectomy

Mater Private Hospital Redland

Mater Private Hospital Redland was established in September 2000 as an extension of the mission of the sisters of Mercy to provide the highest quality healthcare services for the people of the Bayside region.

With a growing community in the Bayside districts, Mater Private Hospital Redland offers patients exceptional care close to their families and friends.

Collocated with the Redland Public Hospital, Mater Private Hospital Redland features a 60-bed, three-level main hospital building incorporating patient wards, operating theatres, day procedure unit, chapel, theatres, reception area and utility rooms. It is combined with a single-level building housing a specialist medical centre, radiology and pathology services.

Our Mission

In the spirit of the sisters of mercy, Mater Health Services offers compassionate service to the sick and needy, promotes an holistic approach to health care in response to changing community needs and fosters highs standards in health related education and research.

Following the example of Christ the healer, we commit ourselves to offering these services to all without discrimination.

Our Values

• Mercy—the spirit of responding to one another
• Dignity—the spirit of humanity, respecting the worth of each person
• Care—the spirit of compassion
• Commitment—the spirit of integrity
• Quality—the spirit of professionalism

At Mater Private Hospital Redland, we understand that having an operation can be a very stressful experience. This booklet aims to alleviate some of your concerns, in keeping with our Mission to offer compassionate, quality care that promotes dignity whilst responding to patients' needs, this booklet aims to alleviate some of your concerns. It explains the general day to day events that may occur during your visit and the things to expect following your discharge.

Each person may require different treatments. This booklet is intended as a guide only.

If you have any questions about your treatment please speak to your Doctor or Nurse.

Our pastoral care team offers a caring support network to all patients. The dedicated members of this team may visit you during your stay and are available at your request to discuss any anxieties or problems that you may have.

Lap Cholecystectomy

Expected Length Of Hospital Stay—Overnight

Date Of Admission:_______________________________________

Planned Discharge Date:__________________________________

Actual Discharge Date:____________________________________

Surgeon:__________________________________________________

Anaesthetist:______________________________________________

Our Expectations

Prior to discharge:

1. You will have no wound swelling or unexpected discharge.
2. You will be passing urine spontaneously.
3. Your pain will be well controlled.
4. You will tolerate diet and fluids.
5. You will be able to mobilise freely.

Your Expectations And Goals

Pre-Admission Assessment

Mater Private Hospital Redland provides a preadmission health assessment on the information you have provided to us. You may receive a phone call if required to clarify any health information you have provided.

This preadmission service gathers information, initiates investigations to prepare you for your surgery, provides information regarding your specific operation and identifies discharge needs.

Things to do before you come to hospital

• It is important for you to bring X-rays and any medications that you take. Your medications need to be in their labelled containers or Webster pack.
• If you are taking any blood thinning or arthritis medications please follow instructions provided by your specialist, as sometimes it is important that these medications be stopped in preparation for your surgery.
• It is necessary that you have nothing to eat or drink (including water, lollies and chewing gum) at least six hours before your operation. Please follow instructions provided by your doctor.
• It is important for you to shower then dress into clean clothes prior to coming into hospital. No skin products are to be used following your shower. (e.g. deodorant, perfume, body lotion, powder)
• As Mater Private Hospital Redland is unable to accept liability for losses it is highly recommended that you leave your valuables at home for safety and security purposes. Please bring essential items only.
• You can expect to be going home the day following your surgery following a visit by your doctor.

The day of your operation

Before your operation

• When you come to hospital proceed to Mater Private Hospital Redland reception. You will be directed to where you will be admitted.
• The assessment form completed at the preadmission service will be reviewed and your health team will plan for your individualised care while in hospital and any support you may require after discharge. Your nurse will also check that your consent form has been signed or organised to be signed before your operation.
• Your nurse will discuss with you any concerns that you may have about your surgery and needs that you may have when you are discharged.
• It is an infection control requirement at Mater that, if you have transferred from another health care facility or you have a history of previous colonisation of multiresistant organisms, nasal, wound and perianal swabs need to be taken.
• The medications you brought to hospital will be collected. Please remember to ask for these to be returned to you when you leave the hospital. Please inform the nurse admitting you if you have been taking any blood thinning or arthritis medications prior to your admission, as these may have needed to be stopped before your operation day. It is usual for you to continue taking your other prescribed medications.
• You will have an identification armband applied. This will stay on for the duration of your stay for identification and safety reasons. If you have any known allergies, and allergy armband will also be applied for your safety.
• Your nurse will take a set of baseline observations (for example, temperature, pulse, blood pressure) and weigh you.
• It may be necessary to clip any hair in the surgical area.
• You will be asked to dress into theatre clothing.
• You will be measured for special stockings (TEDS) and compression sleeves (SCDs) and will need to have these put on prior to theatre.
• You may be prescribed a medication before you go to surgery.
• Before you leave for theatre a pre-operative check list will be completed with you by your nurse. This checklist will be repeated in the operating reception area. Apart from your wedding band, no jewellery or metal is to be worn to theatre.
• You will be escorted to the operating suite.
• It is important that you begin your 'Breathing and Leg exercises" following your operation, when you are awake.

Breathing and circulation exercisesafter your operation

The following exercises help prevent complications such as chest infections and blood clots in your legs. You should do these every hour that you are awake and while on bed rest.

Breathing exercises: take five long and slow deep breaths. Each breath should be deeper than the previous breath. Think about getting the air to the very bottom of your lungs.

Circulation exercises: firmly move your ankles up and down to stretch and contract your calf muscles.

After your operation

• You will stay in the recovery room within the theatre suite after the operation while you waken from the anaesthetic. You will then be transferred in your bed to your room.
• You will have four to five small dressings on your abdomen. You may have a drain; this removes excess fluid from the site of your operation and is usually removed after your doctor visits tomorrow.
• Your nurse will take frequent observations of your vital signs (for example, temperature, pulse, blood pressure) dressings/drains for several hours after the surgery. As you become fully recovered, these become less frequent but remain regular until you leave hospital.
• Immediately following your surgery, you will be resting in bed. When you feel well enough you will be assisted the first time you get out of bed.
• About four hours after you return to the ward, your nurse will assist you to have a wash.
• You may have small amounts of water or ice to suck, then progress from fluids to a normal diet as tolerated.
• If you have pain or nausea, please tell your nurse as there are medications which can be given to relieve this. It is important to be comfortable.
• The drip (IV) is necessary to maintain your fluid intake. This will be removed when you are tolerating adequate amounts of oral fluids.
• You may have an oxygen mask in place whilst you are still sleepy from the anaesthetic.

In preparation of going home

• Your nurse will discuss your follow-up appointment and any discharge arrangements that have been made with you.
• Discharge information will be given to you and your nurse will discuss this with you. If you have any questions, please do not hesitate to ask.
• It is still recommended to perform deep breathing, coughing and leg exercises while you are resting in bed.
• You will recommence your normal medications.
• Please tell the nursing staff if you have any pain so that they may give you medication.
• You may walk as much as you like, short frequent walks are a great way to start.
• You may shower yourself. If your wounds are open, pat them dry with a towel. For dressings still over port sites/wounds, leave them intact for 48 hours and then they can be removed.
• You may have food and fluids as desired.
• Your observations (temperature, pulse) and your wounds will be checked before you are discharged.

Discharge advice following Laparoscopic Cholecystectomy

What to expect:

• You will experience some pain at your wound site. This should be relieved by oral analgesia, for example, Paracetamol—however do not take any more than eight tablets within a 24 hour period.
• You may experience shoulder tip pain for two to three days. This should be relieved by simple pain relieve (as above). Heat packs may also help.
• The wound may look slightly reddened and raised.
• There should be no discharge from the wounds.
• You can remove the dressing over your wounds 48 hours after your surgery.
• You should be mobilising freely, increase your activity as you feel able.
• You should be able to tolerate a normal diet.
• Post operative lethargy often lasts for a month or more. This is normal.

What to avoid:

• High fat foods.
• Excessive activity/heavy lifting.
• Over exertion.

Contacts

Please contact either your General Practitioner (GP) or your nearest emergency department if you experience any of the following after discharge:

• discharge from the wound
• fever
• pain is not relieved with simple analgesia, for example, Panadol/ Panadeine (do not take any more than eight tablets within a 24 hour period)
• nausea and vomiting which does not settle
• any other concerns.

Acknowledgments

Staff of Mater Private Hospital Redland

Carepath Coordinator Mater Private Hospital Redland

Reference: Milliman CareGuidelines: Inpatient and Surgical Care/Ambulatory surgery/ Home Care, 1990 to 2009

Mater Private Hospital

Redland Telephone: 3163 7444

Copyright © 2010 Misericordiae Health Services Brisbane Limited ACN 096 708 922

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