Rectal Surgery. Day Surgery Surgery and Critical Care

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1 Rectal Surgery Day Surgery Surgery and Critical Care This leaflet has been designed to give you important information about your condition/procedure, and to answer some common queries that you may have.

2 You have been referred to have rectal surgery; some of the procedures performed are as follows: EUA rectum Examination under anaesthetic of the rectum. Sigmoidoscopy Using an endoscope (telescope) the surgeon can examine the inside of the sigmoid flexure and lower descending colon (lower parts of the bowel) to determine if the cause of your problem stems from this area. Banding of haemorrhoids Haemorrhoids (piles) are varicose (large and swollen) and often inflamed condition of the veins near the lower end of the bowel. These often bleed and cause pain when you open your bowels. This procedure involves putting a tight band around the haemorrhoid(s) cutting off its blood supply. The haemorrhoid should then fall off. Anal dilatation Dilating (stretching the anus to improve bowel movement. Excision of skin tags/polyps. Surgical excision of skin tags/polyps (projected overgrowth of tissue). Before you arrive Prior to your admission you will have been advised when to stop taking diet and fluids. Please have a shower or bath before your admission. We request that you do not wear make-up, nail-varnish or jewellery (except for wedding ring). Please bring any medication that you normally take (even if infrequent), a dressing gown, slippers and a book or magazine to read. Please leave valuables at home. Following a general anaesthetic please arrange: An adult to escort you home and care for you for the first 24 hours after discharge Not to use machinery, cook, or sign documents for 24 hours Time off work 48 hours (depending on the type of surgery performed, usually 1-2 weeks following banding of haemorrhoids) Not to drive for 48 hours What will happen when I come in for my surgery? Please report to the reception desk. You will be asked to wait in the reception lounge. A nurse will take you upstairs to prepare you for your operation. You will be asked to wear a theatre gown (a locker is provided for your clothing) and your blood pressure will be taken. Please tell the nurse if you have any medical changes or change of social circumstances. The surgeon will come to see you, and take your written consent for your operation if this has not already been done. You will wait for your surgery in a mixed sex seated area. When it is time for your surgery the nurse will

3 walk with you to the anaesthetic room. After the surgery If you have had a general anaesthetic, you will wake up in the recovery suite. When you are fully awake you will be transferred into the recovery lounge (seated area). Light refreshments will be provided. You may experience some discomfort if so, the nursing staff will give you prescribed pain relief on request. A small 'pack' may have been inserted into the rectum during the surgery; your first bowel movement following surgery will remove this. When you are adequately recovered the nurse will provide you with discharge advice, answer any questions that you may wish to ask and arrange for you to go home. At home You may require painkillers after the effects of the anaesthesia has 'worn off'. It is not uncommon for you to feel 'sore'. The surgeon may have prescribed medication for you to take at home (usually lactulose and/or fybogel). If you experience excessive bleeding please contact one of the numbers given in this leaflet for advice. Try to increase the high fibre content within your diet. An outpatient appointment will be sent to you by post to review your surgery (if applicable) usually 4-6 weeks depending on type of surgery. Following discharge, a letter regarding your surgery will be sent to your GP within 48 hours. Benefits You may have experienced: Bleeding Pain Change of bowel habit The surgeon needs to perform an examination for you under a general anaesthetic to determine the cause of your problem. Risks As with any operation, there is a risk of complications from the surgery and with the anaesthetic. However, the risk is very small. There is a very slight risk of faecal incontinence and/or increased flatulence following surgery. During a sigmoidoscopy, there is a slight risk of bowel perforation. If this occurs further surgery may be necessary which could cause an extended stay on an in-patient ward. Bleeding may occur. If the bleeding persists, seek advice. There is a slight risk of infection. If you experience excessive tenderness or persistent oozing, seek advice. Discomfort following surgery is common; please ensure you have adequate painkillers at home.

4 Effects of surgery and anaesthetic If you experience nausea following surgery, drink plenty of fluids and take light meals. Headache is not unusual following a general anaesthetic. Simple painkillers will help to relieve this. Alternatives Increasing the fibre and fluids in your diet may ease symptoms. Ointment (for example GTN) may relieve the symptoms of haemorrhoids. References Contact details within the Trust for patients to obtain additional information Day Surgery Unit (08:00-20:00 Mon-Fri) Your own GP or (out of hours) NHS DIRECT: Day Surgery Unit Pre-operative Assessment Day Surgery Unit Reception/Appointments Concerns and Queries If you have any concerns/queries about any of the services offered by the Trust, in the first instance, please speak to the person providing your care. For Diana, Princess of Wales Hospital (01472) or at the PALS office which is situated near the main entrance. For Scunthorpe General Hospital (01724) or at the PALS office which is situated on C Floor. For Goole and District Hospital (01724) Alternatively you can nlg-tr.pals@nhs.net Northern Lincolnshire and Goole Hospitals NHS Foundation Trust Diana Princess of Wales Hospital Scartho Road Grimsby Scunthorpe General Hospital Cliff Gardens Scunthorpe Goole & District Hospital Woodland Avenue Goole

5 Date of issue: May 2011 Review Period: November 2013 Author: Pre-Assessment Lead Day Surgery, DPOW IFP-024 v3 NLGHFT 2011