On the day of the operation, you will be required to present yourself to the Hospital several hours prior to your booked time in order to be admitted to the hospital (Admitting Dept), be prepped for the procedure (Preoperative Care Center), and review with the attending Surgeon and Anesthesiologist. Usually a Donor and Recipient operation occur across the entire day, with the Donor operation in the morning and the Recipient operation in the afternoon. As such, you will be asked to come to the Hospital at approximately 5:30am to be admitted and leave time for the administrative events that are required prior to entering the Operating Room.
The Admitting desk will send you up to the Preoperative Care Center (PCC) where a nurse will be assigned to you, confirm some details and paperwork, and help you prep for surgery. This usually involves changing into a hospital gown, securing your clothes and valuables, administering preoperative antibiotics, and keeping warm. Your Surgeon and Anesthetic team will then chat with you quickly to answer any final questions and you will then be moved to the Operating Room in a stretcher.
At this point you will again be reacquainted with the Surgical and Anesthesia teams as well as Nursing team (circulating, scrub and relief nurses), and any ancillary staff required for the case (Technicians, Therapists, etc). Be aware that in an Academic Hospital environment, there may be student, resident and surgical fellow housestaff around who may ask you questions and help out before, during and after the procedure. All housestaff are under the direct supervision of the attending physician who oversees all aspects of the day.
For Kidney Donor surgery, a general anesthetic is administered. Under this type of anesthetic, you will not feel any pain, nor be aware of or remember any of the events of the procedure at all. Although there are movies about “waking up” during a procedure, this event is thought to essentially be theoretical in nature and would be an extremely unlikely event. Once the anesthetic has been administered, a breathing tube will be placed to provide access to ventilate the lungs, and additional intravenous lines, arterial lines and oro/nasogastric tubes in preparation for the surgery. Special leg-massagers will be put on you to increase circulation and prevent the formation of clots in the legs during recovery. A catheter will be placed in the bladder to allow the urine to drain.
At this point, the surgical team will position you in the lateral decubitus position, which means that you will be rolled up onto your side on the OR table, with the operative side facing up. You will be fixed on this position through a combination of specialized bedding, cushions, tapes and straps. The incision sites will be marked out (you may see these marks on the skin after the operation as well), and the skin of the operative field will be washed with an antiseptic solution in preparation for surgery.
At this point the surgical team will perform the planned operation to be discussed in the following pages.
After the operation is complete, you will be brought to the Post Anesthetic Care Unit (PACU) to recover from the anesthetic and for close monitoring. When you are well and stable (in about an hour), you will be transferred to an inpatient unit in the Hospital where your family can see you.
You will likely be very tired from the surgical stresses and all the anxiety leading up to the procedure, as well as from the residual anesthetic and painkillers in the system and will want to sleep for a time. Your Surgeon will come to chat with you and your family regarding the details of the procedure and discuss the plan for your hospital stay. If food is offered to you, it will take the form of clear fluids at most and likely just water until the next day. Pain control takes the form of a “super aspirin” called ketorolac and is administered as an IV infusion overnight with supplemental oral painkillers as required.
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