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What happens on the day of my surgery?

Breast surgery changes

Due to changes in our department during the COVID-19 pandemic, we are offering some of our breast surgery at The Royal South Hants hospital Treatment Centre (C level theatres). Prior to your surgery you will have a pre-operative COVID-19 screening with a questionnaire and a swab test.

The hospital operates in line with national guidance and we will require you to wear a face mask on entry and during the majority of your stay with us.

We perform breast surgery at the day surgery unit on D level of the Princess Anne Hospital, or at present the Royal South Hants ISTC. You will need to arrive at the time you are given on the day of surgery. This will be a morning or afternoon session. You can call the unit through the switchboard on 023 8120 6659.

You will be invited for a pre-admission visit, where you can discuss what to expect with a nurse. You will be advised about fasting before your operation, but you should not eat any food six hours before a general anaesthetic and only drink still water up to two hours before the operation. In practice, this generally means for morning operations, eat nothing except still water after midnight and nothing at all from 6am. For afternoon operations, eat and drink nothing except water after 6am the same day and nothing at all from 10am, unless you are told otherwise.

More information about fasting before a general anaesthetic is available on the Royal College of Nursing website.

Arriving at the unit

When you arrive, please check in at reception and take a seat in the waiting area.

The nurses will take you to your bed and begin preparing you for the operation. They will ask you questions, and do some checks. You will be given a pair of thromboembolism deterrent (TED) stockings to wear during your hospital stay to reduce the risk of developing blood clots in your legs (thrombosis) and your lungs (pulmonary embolism). We will give you a hospital gown and a wristband.

Before your operation

The surgeon (or a member of their team) will see you before your surgery to answer any questions you have, check the consent form is signed and to mark the area we will operate on with you. You will also see the anaesthetist.

You may also need to have some pre-operative procedures on the day of surgery:

Breast localisation procedure

This happens in our breast imaging unit on E level, Princess Anne. This may an ultrasound mark drawn on your breast, or a localisation wire placed, this will have been discussed with you beforehand. This will typically happen on the day of surgery.

Sentinel node biopsy procedures

If you are having a sentinel node biopsy of your armpit (axillary) glands, you may also need to visit the nuclear medicine department in Southampton General Hospital to have a sentinel node localisation procedure before the operation. This will involve an injection and in some selected cases further nuclear medicine scans. This may happen on the day of surgery or the day before.

You may also receive an injection of blue during your operation, this will typically give you a blue stain where it is injected, a grey or blue complexion for 24 hours, and your urine or faeces may be discoloured for the first 24 hours. These all pass over time.

The nuclear medicine department is on D level of Southampton General Hospital (enter through main entrance C level, turn right onto West Wing, go up one level, then turn towards East Wing, and you will see a purple wall with the nuclear medicine entrance sign).

After your operation

After the operation, you will be taken to the recovery area next to theatres to wake up after the anaesthetic. Patients undergoing day case surgery will usually go home approximately two to four hours after the operation if all is well. You will be given refreshments after surgery.

Occasionally day case patients may need to stay overnight, if they have not recovered sufficiently after the operation or anaesthetic. This would usually be on Bramshaw Ward in the Princess Anne Hospital. Visiting hours on Bramshaw Ward are from 3 to 5pm and 7 to 8.30pm, maximum of two visitors per patient. You can call the ward on 023 8120 6035.

If your surgery is in the Royal South Hants NHS Trust ISTC this will be on the ISTC ward.

Your surgeon and the pre-admission team will discuss whether you are suitable for day case surgery or if an overnight stay is required. Patients undergoing reconstructive procedures typically spend 2-7 days, depending on the type of procedure and your post-operative wound care requirements. You will be given advice on your recovery, stitches, dressings, and any drains that may have been used (plastic tubes to drain fluid away from the operation site) and when they will be removed.

You will usually be seen in clinic two weeks after surgery for the results (after the specimen has been fully analysed under the microscope by our pathologists), to check your wounds have healed properly and to discuss whether any further treatment may be necessary.

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