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Mr. Mark Falworth, Consultant Orthopaedic Shoulder & Elbow Surgeon, London, Watford, Stanmore, UK | Information | Preparation for Surgery

Preparation for Surgery

Once we have agreed to proceed with surgery, a number of tasks will be needed to be undertaken before we can proceed.

If you are insured, you will need to inform your insurers as to the plan and give them a Procedure Code(s) which will notify them as to the type of operation you will require. Once agreed, an Authorization Code will be issued to you. You will then need to inform my office of this so that we can then proceed with your hospital booking. Once booked with the hospital, the date of your operation will be confirmed and you will be notified as to what time to present to the hospital.

Depending on the nature of your planned operation, a pre-assessment may be necessary. Although most key-hole / arthroscopic procedures do not require a formal pre-assessment, larger procedures such as a shoulder or elbow replacement will. In such cases you will be invited to the hospital in the one or two weeks prior to your operation for a number of investigations will be undertaken. You should usually take most of your normal medications prior to your operation, however if you have been prescribed an anticoagulant or antiplatlet medication such as aspirin, apixaban, clopidogrel or warfarin, you should notify Mr. Falworth so that arrangements an be made for them to be stopped prior to your operation. Failure to do so may result in your operation being postponed.

On the day of your operation you will be asked to arrive at the hospital at a certain time. This will usually be 1-2 hours before the time of you operation as the nursing staff will need some time to prepare you for surgery. Any jewelry, including rings, should be removed form the hand/arm that is due to have surgery. This is to aid sterility but to also minimise any risk should your arm swell following the procedure.

Remaining ‘nil by mouth’ prior to you surgery is important. In general the following guidelines should be followed;

  • If you are arriving at the hospital between 07.00 and 08.00hrs, have no food after midnight but drink a tumbler of water at 05.00hrs, then remain ‘nil by mouth’.
  • If you are arriving at the hospital between 12.00 and 14.00hrs, have no food after 07.00hrs but drink a tumbler of water before 11.00hrs, then remain ‘nil by mouth’.
  • If you are arriving at the hospital after 15.00hrs have no food after 10.00hrs but drink a tumbler of water three hours before you arrive at the hospital, then remain ‘nil by mouth’.

Once you have been admitted into your hospital room, Mr. Falworth will see you and run through the operation with you again before consenting you for the procedure. His anesthetist will also see you to run through the anaesthetic and the likelihood of using an interscalene block to help optimise your surgery.

An interscalene block is a technique whereby the anaesthetist undertakes an ultrasound guided injection to numb the nerves that run into your shoulder and arm such that you no longer can feel or move your arm. Although you will still receive a general anaesthetic, the use of the interscalene block should minimize any discomfort or pain that you would otherwise experience in the first 24 hours after the operation. Furthermore, as less potent drugs will be necessary during your anaesthetic, you should feel less drowsy or sick following the procedure such that your early recovery following the procedure is quicker. However, until the sensation returns to your arm, it is imperative that you remain in your sling so that you don’t inadvertently injury it.