Robotic Prostatectomy Pre Procedure Instructions
The following instructions are additional information that may help ease any anxiety regarding our upcoming surgery. If at any time you have a question(s) please do not hesitate to contact me or my Surgical Coordinator, Debbie Finateri. Remember the only silly question is the one you think of but do not ask!
Do not consume any aspirin, or aspirin containing products, or non-steroidal anti-inflammatory agents (Motrin, Advil, Alleve, Vitamin E, NO VITAMINS OR MINERALS EITHER ) for 7 – 14 days prior to the surgery. WARNING, many over-the-counter cold and flu remedies containing aspirin. Please refer to the enclosed sheet for a more complete list. Tylenol is okay.
You will need to see your internist/primary care physician WITHIN 30 DAYS of the surgery for your medical clearance evaluation. If you do not have a primary care doctor or a local physician we will provide a recommendation to an excellent physician affiliated with White Plains Hospital Center. It is fine if you have a local physician and he or she is not affiliated with White Plains Hospital Center. That doctor can provide you with your medical clearance evaluation.
PRE OPERATIVE PREPARATION AND DIET:
On the day prior to surgery please consume only clear liquids. This includes water, Gatorade, chicken or beef consume, Jello, tea. At 1:00pm, the day prior to surgery, please consume one, 10ounce bottle of Citrate of Magnesium. This is available at your local drug store and does not require a prescription. Please push the fluids so that you are well hydrated prior to surgery. Gatorade is a good idea.
PRE SURGICAL DIET TO BE FOLLOWED ENTIRE DAY BEFORE YOUR SURGERY
Fruit Juices: Apple, White Grape Juice, Gatorade, grape, strained orange juice ( we don’t care what color you drink).
Soups: Broth, bouillon, consomme’
Desserts: Flavored gelatins, fruit flavored ices, popsicles.
No milk or milk products are allowed. This diet does not meet the recommended dietary allowances of the National Research Council for any nutrient.
The entire day prior to surgery, please follow the above diet. At 1:00p.m., please take one bottle of Citrate of Magnesium. This may be purchased at your local pharmacy and not prescription is needed. Follow the instructions on the bottle (best if refrigerated).
REMINDER: DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT, THE NIGHT PRIOR TO SURGERY, AFTER MIDNIGHT!!
Please arrive at the White Plains Hospital Center, entrance is on Davis Avenue, White Plains, New York, Ambulatory Surgery Department (3rd Floor) when you arrive. WE WILL give you the time of arrival. Don’t worry about the inclement weather. I will be there for your surgery. If Hurricane Floyd did not stop me, nothing will!
I will meet you and your family prior to the procedure and immediately after. The surgery will take approximately 2 hours, but do not worry if it goes longer. Remember, I am not in any rush and neither are you.
Post-operatively, you will go to the Recovery Room (usually 1 to 3 hours) and from there to the floor. You will go to either 5E or 5F. Excellent nurses staff these floors. They have been specifically trained to care for our Prostatectomy patients. You will find that they are caring, attentive and friendly, so you will NOT need a private duty nurse.
Please bring whatever clothing and personal items that will make you comfortable. Some suggested items are a bathrobe, slippers or sneakers. GET READY TO WALK!! I will personally get you out of bed and walking.
On average you will spend 2 to 3 days in the hospital. If you require longer hospitalization do not worry, we work for you not the insurance company.
POST OPERATIVE INSTRUCTIONS:
Do not worry; you will be fine when you go home. We are always available and you can reach us 7 days a week, 24hours a day. You will not get a resident or intern. We are just a phone call away. Prior to leaving the hospital you will receive in-depth instructions on taking care of your catheter. Don’t worry … you will become an expert at catheter care, and it’s not as bad as it sounds.
On average, you will be discharged on post operative day 2 or 3. You will be discharged with the catheter and staples in place.
You will resume all of your regular medications (such as blood pressure medications) unless otherwise specified. Please avoid aspirin, or aspirin containing products and non steroidal anti-inflammatory medications for 14 days after the surgery unless otherwise specified. In addition to your regular medications, you may Tylenol which should suffice for post- operative pain. If this is not providing you with enough pain relief, you will also have a prescription for Tylenol #3 one tablet every four hours if needed for pain.
Prior to discharge, you will be started on a regular diet. Do not consume large amounts of food when you go home. Small, frequent meals are better for you than large, banquet-type meals. Avoid fried or greasy foods at first. Again, light meals are better initially. Please consume prune juice and prunes with breakfast and lunch to avoid post-operative constipation. If you develop loose bowel movements, cut back or eliminate the prunes. If you are constipated and the prune approach is not working, please call. PLEASE DO NOT USE SUPPOSITORIES AND NO ENEMAS!!! IT IS ALSO VERY IMPORTANT THAT YOU DO NOT STRAIN TO MOVE YOUR BOWELS. WE WILL GET YOU MOVING!!
Loose-fitting clothing is best so that you can go out of the house with your catheter in. You should not be house bound. Sweat pants are wonderful and while the catheter is in, you may find it more comfortable to do away with underwear.
CATHETER CARE: (I WILL GO OVER THIS WITH YOU WHILE YOU ARE IN THE HOSPITAL)
On average, the catheter remains in place for a total 14 days (this includes the hospitalization days). The catheter has two channels. The urine drains through the larger hollow tube. This attaches to the leg bag or evening bag. The yellow tube is the valve for the balloon. It is important that the catheter is not put under any tension. The catheter should be taped and secured to your thigh. NO TENSION should be placed on the catheter. Remember to “keep slack in the line”. Occasionally you may have a bladder spasm and urine may come out around the catheter. IF ALL OF THE URINE IS COMING OUT AROUND THE CATHETER AND NOT THROUGH IT, PLEASE CALL US IMMEDIATELY. THE CATHETER MAY BE CLOGGED.
POST OPERATIVE VISITS:
Patients are seen in the office on post operative day #7 for the removal of the staples. This does not hurt!! The foley catheter is removed on day #14. When you come to the office for the catheter removal, you should bring along briefs (jockey shorts). You should also bring along male undergarment pads. These are available in any drug store such as CVS or Rite Aid. The pad can be easily placed in the brief. This is much easier than dealing with the complicated straps of garments such as Depends. You will be given three days of antibiotics after the catheter is removed (usually Levaquin or Ciproflaxacin). You will be instructed to call the office approximately three hours after the tube has been removed.
Day #7 Staples removed
Day #14 Catheter removal
Day #21-24 Routine Post Operative visits
Please call our office and speak with either Brenda or Debbie and they will be able to schedule these visits. Routine Post Treatment visits are every 3 months for 2 years; every 6 months for 3 years; and annually thereafter.