Preparation (Before)

Physical fitness

It is important to prepare for surgery as if it were a sporting event. Before surgery, you should try to build up your best possible physical condition:

• Continue or increase your physical activities (running, swimming, cycling, tennis…).
• If you cannot practice any sport, you are encouraged to go for walks as regularly as possible.
• If necessary, sessions of respiratory physiotherapy may be prescribed.

• Take 2 showers with a liquid antiseptic soap or chlorhexidine-based cleanser (e.g. Hibiscrub soap®…).

– The day before the operation

– The day of surgery

• Do not apply make-up before the operation.
• Do not put nail polish on your nails.
• Do not bring valuables and jewelry to the hospital.

• If you wear eye lenses
• If you have prostheses: hip, knee, teeth
• If you have a pacemaker
• … other

Nutritional evaluation:

• If there is no significant weight loss during the pre-operative period, no dietary supplements are necessary.
• If significant weight loss during the pre-operative period, intake of high-calorie, high-protein supplements 2 to 3 times a day between meals is strongly recommended.
• In case of significant preoperative weight loss, an  appointment with the dietetics service for nutritional advice will be scheduled.
  +32 2 614 20 71

Examples of nutritional supplements: Nutridrink®, Fortimel®…

Preoperative diet:

Strict low-residue – fibre-free diet for 7 days

Link to chapter: Nutrition

Eve of the surgery:

• The day before surgery, you will be given carbohydrate-rich energy drinks around 10pm and again 2-3 hours before surgery. The purpose of these carbohydrate-rich energy drinks is to stimulate digestion so that transit can resume after surgery as soon as possible. The aim is to minimize the period of fasting, which is detrimental to the recovery and the healing process.

• The day before surgery: 2-4 boxes of Nutricia preop.

• 2 – 3 hours before surgery: 2 boxes of Nutricia preop.

• A dose of oral antibiotics is administered to reduce the risk of fistula and sepsis postoperatively.

  • Ciproxin® 500mg 1co/dr + Flagyl 500mg 1co/dr

Stop eating and drinking

Besides the examinations carried out for the diagnosis of the disease, there are also examinations required for the anesthesia department.

• Preoperative investigations such as an electrocardiogram (ECG), chest X-ray and blood tests are requested depending on the patient’s general condition and history.
• Patients under 65 years of age in good general condition, will only require a blood test in most cases.
• Appointments with the anesthesia, pulmonology or cardiology departments will be requested depending on the patient’s history and general condition.

Pulmonology department (lung diseases)

+32 2 614 27 10

+32 2 614 20 00 

Cardiology department

+32 2 614 25 40 

• If preoperative examinations were carried out, external to the Europe hospitals, do not forget to bring them with you on the day of surgery or at the anesthesia consultation!
  

Laparoscopic colon resection – left colectomy is performed under general anesthesia.

• During the surgical consultation, you will be given an anesthesia questionnaire. This should be completed before the scheduled anesthesia consultation or before admission to the hospital.
• Please perform any preoperative examinations (chest X-ray, ECG, blood tests) or preoperative consultations (pulmonology , cardiology) before the anesthesia consultation.  If the tests or consultations (e.g. cardiology / pulmonology) are performed outside the Europe hospitals, please remember to bring them with you to the anesthesia consultation.
  
• Patients admitted on the day of surgery, who are in good general condition, will be consulted in the operating theatre just before surgery.
• If you suffer from sleep apnea and are treated with CPAP therapy, remember to inform the anesthetist and to bring your device with you for the duration of your stay.
• Patients admitted to hospital the day before surgery will be consulted by the anesthetist in the ward the day before surgery.
• Patients wishing a consultation can request one or contact the anesthesia department:

+32 2 614 20 30

+32 2 614 40 20

• There is no unanimity regarding the preparation of the colon before surgery; it may change depending on the patient’s symptoms and the surgeon’s preferences. The same preparation (drinking 2-3 l of laxative) as for colonoscopy is not always necessary.
• It is recommended to follow a strict low-residue – fibre-free diet 7 days before surgery.

Link to the section : Nutrition

• A Fleet® (laxative) in the morning at home the day before surgery and a Fleet® on the eve of surgery. 
• A dose of oral antibiotics is administered to reduce the risk of sepsis postoperatively:  Cirpoxin® 500mg 1co/day + Flagyl® 500mg 1co/day

Electric clipping (no shaving) of the surgical field is not systematically required. At the surgeon’s request, it can be performed at home or on the day of surgery.

Clipping area: From the nipples, the entire abdomen to the top of the thigh, including the pubic area.

During the consultation, home medication will be reviewed.

Particular attention will be paid to anticoagulants and anti-diabetics, some of which should be stopped after medical advice.

• Anticoagulants : Plavix®, Clopidogrel®, Sintrom®, Marcoumar®, Xarelto®, Pradaxa®, Eliquis®…
• Anti-diabetics : Glucophage®, Metformin® …

Chronic intake of steroids and non-steroidal anti-inflammatory drugs, delay healing and may increase the risk of fistulae and open wounds.

• Anti-inflammatory drugs – corticosteroids: Brufen®, Nurofen®, Cataflam®, Medrol® …

Check your medication in the section on medication.

There you will find information on whether or not to stop common medicines and the number of days that they should be stopped before surgery.

Link to the chapter: Medication

During the consultation, you will be informed regarding the date and time of the hospital admission.

• If you are admitted on the day itself, you should present yourself to admission at 7 am, unless the surgeon or the secretary informed you of a different time.
• If you are admitted the day before surgery, hospitalization is between 4pm and 5.30pm. Unless the surgeon or secretary informed you of a different time.

Length of hospital stay

Length of stay : 3 – 7 night stay.

• 3 – 7 night stay: Discharge on the day before 2pm.

• During hospitalization, it is important to have the various certificates completed quickly (insurance, mutual insurance, sports club certificate, disability certificate, etc.). If possible, issue the certificates already in the operating theatre.
• Discharge is planned when the patient can eat independently and mobilize autonomously.
• For patients who are not independent, it is important to contact the social services quickly, even before hospitalization, to organise home care or post-operative rehabilitation.

Social service contact details:

+32 2 614 32 28

+32 2 614 92 92

Pre-operative sequence of events:

Before you go to the operating theatre, you will be asked the following questions :

• Complete the anesthesia questionnaire
• Contact details (spouse, children…)
• To urinate
• Remove jewelry, contact lenses, dentures, hearing aids….
• Put on the surgical gown

You will be taken in bed to the operation quarter. In the operating theatre, you will see the anesthesist and also your surgeon, therefore you will still have the opportunity to ask questions.

For your safety, you will be asked at several times for your name and the reason (type of procedure) for your presence in the operating theatre.

What should I bring to the hospital?

Comfortable clothes and supplies for your personal hygiene:

•  Pyjamas, nightgown and dressing gown
• Loose-fitting trousers, sweatpants
• T-shirts, light jumpers
• Slippers or flip-flops
• Toiletries
•  Soap, shower gel and shampoo
• Toothbrush and toothpaste
• Deodorant
• …

To pass the time, to have fun:

• Reading (books, magazines), games…
• Laptop, tablet (Please bring headphones to listen to music, watch films or series without disturbing your neighbor).
• You can bring photos or a personal items to make you feel less lonely and a little more “at home”.