You have chosen to have your prostate removed by our robotic surgery technique here at Queen Elizabeth University Hospital. This leaflet will tell you what to expect during your hospital stay and answer many questions you may have about your care after leaving hospital. Please note that throughout this document we may state times such as, 1 hour or 2 days, these times are not definite and may vary. There is therefore no cause for alarm if things do not happen at the exact time scale described. Each of our patients is an individual and care can be changed according to how quickly a person recovers from their surgery. If you have to stay in hospital for longer than initially anticipated it is because the doctors feel that it is the best and safest thing for you to do. This information document is one of two in a series about your care. You should have had an information booklet on robotic assisted laparoscopic prostatectomy explaining the procedure. If you have not received this information leaflet please contact your Consultant’s secretary and this can be mailed out to you.
You will be asked to arrive at the hospital early in the morning, to the Same Day Admissions Unit (SAU), located on Level 2. You should not have had anything to eat or drink since midnight. For the 24 hours preceding surgery, you should avoid solids but have as much as clear fluids (including clear soups, tea, coffee and juices) as you wish. We suggest carbohydrate rich drinks such as Lucozade, You should bring a small overnight bag with wash things, pyjamas, slippers and comfortable loose fitting clothes to change into when you go home. Tracksuit trousers are ideal as your tummy may feel bruised and slightly swollen after the operation.
Upon admission to the SAU, you will be seen by a nurse who will ask you questions about your health, take your blood pressure, temperature and pulse, fit you with anti blood clotting stockings. You will then be seen by your anaesthetist and by a member of your surgical team who will gain your written consent for the operation (just a signature is required). They will ensure that you understand what is going to happen and why we are doing the operation. If you have any questions for any of these members of staff do not be afraid to ask them. You will then get changed into a hospital gown and walk to theatre with one of the nurses
Going to theatre
At the operating theatre, you will be escorted to the anaesthetic room; this is where you will go to sleep. The anaesthetist will put some oxygen on your face to breathe and place a needle in the back of your hand which all of your anaesthetic medicines can be given through. Other monitoring equipment will be put in place such as a heart monitor. Although this can be a little frightening it is there to ensure your safety throughout the procedure. You will see quite a few different people in the department; again do not be alarmed, they all have roles to play in your care.
You will then be given medication to make you go to sleep. You will be asleep throughout your procedure. We take great care of your arms and legs to make sure that you are protected and safe at all times. Your tummy hair and a section of hair on your thigh are removed and your tummy is painted with a sterile cleaning solution, we do clean this off at the end of the procedure but do not be alarmed if you still have an orange colour on your skin. It will wash off after a couple of showers.
During the operation we tip your head down, this helps us gain access to your pelvis which is where the prostate is. Being in this position can cause some people to have problems when they wake up such as:
- Swelling of the area around and including the scrotum
Do not be tempted to rub your eyes when you wake up as this may cause very minor damage. The staff looking after you will remind you not to do this.
- Facial swelling, this will settle very quickly after the operation
Before the operation is over your anaesthetist will start giving you pain relief so that you wake up in as little discomfort as possible. Your surgeons will also put local anaesthetic in your tummy wounds to assist with pain control.
Return to recovery
After surgery, you will be transferred to the Recovery area. When you wake you will have:
- a drain – to remove any blood and fluid which may otherwise build up
- a catheter – along the urethra (waterpipe) and into the bladder to drain urine
- several drips through a fine plastic needle placed in the back of your hand – to replace any fluid you lost during the operation.
- and oxygen – to help you breathe
These are all perfectly normal following major surgery.
Once the staff are happy that you are safe to return to the ward, you shall be transferred to ward 11C where you will have a single, en-suite room.
The staff will ensure that your pain control is working. It is likely that you will have some pain and discomfort from the areas where the ‘ports’ entered the tummy and also from having had your tummy blown up with gas during the procedure. We try to reduce any strong pain killers such as morphine as quickly as possible as this enables you to get out of bed and start mobilising. You should, however, take regular painkillers throughout your stay in hospital.
Getting out of bed
We nurse you sitting up as much as is comfortable for you to do so after the surgery as this helps your recovery. You will be encouraged to get out of bed and sit in a chair as soon as four hours after your operation and then we encourage you to start walking around your bed with help from the nursing team. This is all part of our rapid recovery programme and helps prevent some of the common risks associated with surgery such as chest infection and blood clots. You will also be encouraged to perform deep breathing and leg exercises.
Eating and drinking
You may eat and drink as soon as you feel able to do so. If you feel nauseated (sick) do tell the nursing staff and we can give you medicine to stop the feeling. The morning after surgery we expect that you will be able to sit out of bed to have your breakfast and would encourage you to sit out of bed for all meals throughout your stay with us.
- Once on the ward we will encourage you to take at least hourly strolls around the ward going a little further each time. Listen to your body and do not over exert yourself. Go back to bed and rest as much as you need
- Your drain and any remaining needles in your hands will be removed and dressings changed/removed
- You will be encouraged to wash and freshen up and if you prefer at this stage you may get changed back into your own clothes
A decision regarding when you are due to go home will be made by your surgical team. This decision will be based on how well you are moving around, how well your pain is being controlled, if you are nauseous and how far you live from the hospital.
Our expected discharge time is 24 hours from surgery so please be prepared to go home at about 4pm the day after your operation. Some patients stay with us a little longer for various reasons but we find that the majority of patients recover sufficiently well to go home this early. You will still require plenty of rest when you go home as your body has undergone major surgery but being in your own environment is generally considered to be better for you. We would ask that there is someone at home (at least for the first few days) to help look after you. We expect you to continue with gentle exercises and daily walks increasing the amount you do every day.