Before Surgery

Anesthesia Team Visit

Why is an anesthesia team visit required?

Dr. Maher Abbas works with a superb anesthesia team to provide you safe and quality surgical care.  A few days prior to your operation, you will have the opportunity to meet with an anesthesia colleague to review your medical record, order any needed tests and evaluations, and discuss the care you will receive on the day of your surgery.  Come prepared with any questions.  Dr. Maher Abbas recommends that you bring a family member or a friend to be present as a lot of valuable information will be shared to guide your care.  Bring a list of the medications you take or any relevant outside medical records (such as notes from your medical doctor, cardiologist, lung doctor or reports of EKG, XRAYs, blood work).

Type of anesthetics

When you visit with the anesthesia team, you will have the opportunity to discuss the anesthetic that you will receive for your operation.  Dr. Maher Abbas performs his abdominal and pelvic operations under general anesthesia.  For anorectal (proctologic) operations, the option of a spinal anesthetic (anesthesia administered into the spine with numbing of the area of the operation) is an option for a select group of patients unless Dr. Maher Abbas feels that you are better suited for a general anesthetic based on the complexity of your operation.

Bowel preparation and fasting instructions

For both anorectal surgical procedures and abdominal surgical procedures, follow the instructions given to you by Dr. Maher Abbas or his nurse during the clinic visit [see section on Bowel Preparation-Anorectal Surgery and Bowel Preparation-Abdominal Surgery].

Your Medications

The anesthesia team will provide you with specific instructions regarding what, how, and when to take your usual home medications the morning of surgery.

Additional tests and evaluations

As deemed necessary by the anesthesiologist, blood tests and any evaluations will be ordered.  If there is a need for consultation with an additional subspecialty to optimize your care (such as a heart, kidney, or lung doctor), the appropriate consultation will be arranged.

Blood transfusion

If there is a potential need to give you blood products during major abdominal or pelvic surgery, the anesthesiologist will discuss with you the process of obtaining such blood products, how they are administered, and any risks involved.

Post-operative recovery

After your operation, you will be moved from the operating room to the postoperative recovery area.  Once you meet the recovery criteria, you will be transferred to the floor.  Dr. Maher Abbas and his anesthesia colleague recommend the Enhanced Recovery After Surgery (ERAS) protocol for the majority of patients after abdominal surgery.   The ERAS protocol promotes the early removal of tubes and catheters, early ambulation, same day feeding, and minimizing the use of opioids pain medications.   The anesthesiologist can discuss with you the general elements of the ERAS protocol.

Pain control

During your visit, you will be able to ask questions about pain control in the recovery area and during your hospital stay.  Dr. Maher Abbas works closely with the anesthesia team to ensure that your pain is controlled.  In addition to oral medications, intravenous injections of pain killers can be administered.  For anorectal proctologic surgery, a local block will be performed at the end of your operation in order to provide you with several hours of pain control when you wake up.  For minimally invasive surgical procedures (laparoscopic camera surgery), Dr. Maher Abbas recommends the Transversus Abdominis Plane Block (TAP Block) for postoperative pain control.  With years of expertise, he finds that the TAP block is currently the most effective way of controlling the pain after laparoscopic surgery.

Any questions?  Contact Dr.  Maher A. Abbas’ office nurse here.