Our expert team members shall help you to prepare you for surgery. You are strongly advised to stop smoking, stop drinking alcohol, try to improve your diet, lose weight, or actively exercise before surgery.
In most cases, you will need some tests before your surgery. The tests routinely used include:
1. Blood tests to measure your blood counts, your risk of bleeding or infection, and how well your liver and kidneys are working. Your blood group type is also be checked in case you need blood transfusions during the operation.
2. Chest x-ray and ECG (electrocardiogram) to check your lungs and your heart’s electrical system.
3. USG/CT scans/ MRI to look at the size and location of the tumors and see if cancer looks like it has spread to nearby tissues.
Anaesthetic Assessment before Surgery:
Our expert team of Anaesthetist will ask you questions pertaining to your health and to assess your fitness for surgery. You are requested to tell them in detail about your current and past medical ailmentAnaesthesia is the use of drugs to make the body unable to feel pain for a period of time. General anesthesia puts you into a deep sleep for the surgery. It is often started by having you breathe into a face mask or by putting a drug into a vein in your arm. Once you are asleep, an endotracheal or ET tube is put in your throat to make it easy for you to breathe. Your heart rate, breathing rate, and blood pressure (vital signs) will be closely watched during the surgery. A doctor watches you throughout the procedure and until you wake up. They also take out the ET tube when the operation is over. You will be taken to the recovery room to be watched closely while the effects of the drugs wear off. This may take hours. People waking up from general anesthesia often feel "out of it" for some time. Things may seem hazy or dream-like for a while. Your throat may be sore for a while from the endotracheal (ET) tube.
RECOVERY FROM SURGERY
Your recovery right after surgery depends on many factors, including your state of health before the operation and how extensive the operation was performed.
You may feel pain at the site of surgery. We aim to keep you pain-free after surgery with the help of latest and most effective technique or analgesic (pain relieving medicine).
1. You may also have Ryle’s Tube (tube going through the nose to stomach) that drain out intestinal fluid. This tube helps to relieve nausea and vomiting after surgery and usually removed 1-2 day after surgery.
2. You may also have “Tube” (called a Foley catheter) draining urine from your bladder into a bag. This will be taken out soon after surgery, once you are comfortable enough to go to the bathroom.
3. You may have a tube or tubes (called Drains) coming out of the surgical opening in your skin (incision site). Drains allow the excess fluid that collects at the surgery site to leave the body. Drain tube will also be removed once they stop collecting fluid, usually a few days after the operation.
Leg Stocking / Compression boot
As you remain in bed on the day of surgery, circulation of blood in leg become sluggish that may increase the possibility of thromboembolism. To minimise it, you will be wearing leg stocking/ pneumatic compression boot to improve your leg circulation thus minimising the risk of thrombosis.
Eating and Drinking
You may not feel much like eating or drinking, but this is an important part of the recovery process. Our healthcare team may start you out with ice chips or clear liquids. The stomach and intestines (digestive tract) are one of the last parts of the body to recover from the drugs used during surgery. You will need to have signs of stomach and bowel activity before you will be allowed to eat. You will likely be on a clear liquid diet until this happens. Once it does, you may get to try solid foods.
1. Our healthcare team will try to have you move around as soon as possible after surgery. They may even have you out of bed and walking the same day. While this may be hard at first, it helps speed your recovery by getting your digestive tract moving. It also helps your circulation and helps prevent blood clots from forming in your legs.
2. Our team shall also encourage you to do deep breathing exercises. This helps fully inflate your lungs and reduces the risk of pneumonia. You are advised to take deep breaths and cough every hour to help prevent lung infections. You will use an incentive spirometer (a small device used in breathing exercises to prevent complications after major surgery) 10-15 times every hour.
Once you are eating and walking, all tube/drains placed during surgery are removed, and then you may be ready to go home. Before leaving for home or health care team shall give you detailed guidance regarding diet, activities, medications & further plan of treatment.
RISKS & SIDE EFFECTS OF SURGERY
There are risks that go with any type of medical procedure and surgery is no longer an exception. The success of surgery depends upon 3 factors: type of disease/surgery, the experience of the surgeon and overall health of patients. What’s important is whether the expected benefits outweigh the possible risks.
Doctors have been performing surgeries for a very long time. Advances in surgical techniques and our understanding of how to prevent infections have made modern surgery safer and less likely to damage healthy tissues than it has ever been. Still, there’s always a degree of risk involved, no matter how small. Different procedures have different kinds of risks and side effects. Be sure to discuss the details of your case with our health care team, who can give you a better idea about what your actual risks are. During surgery, possible complications during surgery may be caused by the surgery itself, the drugs used (anesthesia), or an underlying disease. Generally speaking, the more complex the surgery is the greater the risk. Complications in major surgical procedures include:
1. Complications related to Anaesthesia : Reactions to drugs used (anesthesia) or other medicines. Although rare, these can be serious because they can cause dangerously low blood pressures. Your doctors will watch your heart rate, breathing rate, blood pressure, and other signs throughout the procedure to look for this.
2. Complications related to underlying medical illness like heart disease, diabetes, kidney disease, obesity, malnutrition.
1. Lung : Pneumonia, Atelectasis (collapse of lung), effusion (fluid in chest) can occur, especially in patients with reduced lung function, such as smokers. Doing deep breathing exercises as soon as possible after surgery helps lessen this risk.
2. Thrombosis (blood clot) in leg & embolism (blood clot) in lung :Blood clots can form in the deep veins of the legs after surgery, especially if a person stays in bed for a long time. Such a clot can become a serious problem if it breaks loose and travels to another part of the body, such as a lung. This is a big reason why you will be encouraged to get out of bed to sit, stand, and walk as soon as possible.
3. Cardiovascular: Myocardial infarction (heart attack), Arrhythmia (irregular heartbeat), Stroke (cerebrovascular accidents).
4. Kidney & urinary tract infection, acute kidney failure if patient has uncontrolled/non-responding infection.
3. Complications related to Specific Operations
1. There are specific complications related to type of surgery. You are encouraged with discuss in detail with our health care team before you give your consent for surgery.
2. Bile leak
4. Complications related to Major Surgery
1. Infection : Infection at the site of the wound, lung and urinary infection. Infection risk is more if intestine is perforated before surgery, operated for colon and rectum, stent in placed in bile duct to relieve jaundice or intestinal joint is leaking.
2. Bleeding: The risk of bleeding during or after surgery is more if a patient taking blood-thinning medicine until the day of surgery or having liver dysfunction. Bleeding during surgery that may cause you to need blood transfusions. There is a risk of certain problems with transfusions, some of them serious. Still, some operations involve a certain amount of controlled blood loss. Bleeding can happen either inside the body (internally) or outside the body (externally). It can occur if a blood vessel sealed during surgery opens up or if a wound opens up. Serious bleeding may cause the person to need another operation to find the source of the bleeding and stop it.
3. Leakage from anastomosis (joint of anastomosis) & fluid collection in tummy.
4. Blockage of intestine (Intestinal obstruction)
LIFE AFTER SURGERY
1. Following treatment, you may feel the change in your taste. This improves over a time and we encourage having health food habits like fresh vegetables, fruits, and high protein diet.
1. Along with healthy food habits, we also encourage for exercise. Exercise improves your health in different ways: It improves your heart and circulation, makes your muscles stronger & makes you feel happier. You should do your regular activities like walking, and rather increase day by day. Weight lifting and strenuous exercise are avoided for initial 2-3 months.
Follow up care
1. You'll need regular checkups after treatment for liver cancer. This help to find out any change in your recovery. Sometimes liver cancer comes back after treatment. Our healthcare team will check for return of cancer. Checkups may include a physical exam, blood tests, ultrasound / CT scan.
2. If you have any health problems between checkups, you should contact our healthcare team. Report to our health care team, if you have any redness/ swelling or discharge of any type of fluid from your operative incision site, pain abdomen, vomiting or fever, breathing difficulty etc.