FAQ – Frequently Asked Questions

What does Ambulatory Surgery mean?

Surgical patients are kept in the hospital only for a day or so, depending on the surgery. Patient assessment is done as outpatient. Admission the night before or the day of surgery. Discharge from hospital is done as soon as possible.

Reduced stay in hospital means reduced bill for surgery.

Nurses, drugs and doctors are geared up to mobilize patients early and motivate quick recovery.

How is Ambulatory Surgery Centre (ASC) different from a large hospital?

Consultation rooms, lab, xrays and pharmacy are kept close so that patient is seen in an easy atmosphere.

Discussion about surgery and anesthesia are done as outpatient so that the admission time is minimal.

Area needed for the ASC is also smaller, but theaters are equipped with modern measures like laminar flow, Heba filters to keep infection rates very low.

What surgeries are possible in Ambulatory Surgical Centres?

Almost any surgery done in a large hospital is carried out efficiently in ASC.

General surgery includes gall bladder removal for stones, appendicectomy, hernia surgery, obesity surgery, uterus removal, fibroid ( from Uterus) removal , family planning surgery, ENT surgeries like tonsillectomy, adenoidectomy, mastoidectomy are all very common.

What specialties are available in ASC?

General surgery, medical ( endoscopy, colonoscopy), surgical gastro enterology, advanced laparoscopy, bariatric surgery, Arthroscopy, ENT surgery, Gynecological surgery, Urology , Plastic Surgery are all easily available here.

Why the increasing success in Ambulatory surgery?

This is largely due to correct patient selection, anticipatory treatment of pain before it occurs (preemptive analgesia) and appropriate discussion with relatives who will look after the patient at home.

What are the symptoms of gall stones?

Common symptom of gallstones is pain in the stomach area or in the upper right part of the belly.

The pain may start suddenly in the center of the upper belly and spread to the right upper back or shoulder blade area. It is usually hard to get comfortable. Moving around does not make the pain go away. It prevents you from taking normal or deep breaths. It generally last 15 minutes to 6 hours or more.

Gallstone pain can cause vomiting, pain and pressure. Pain that occurs with a fever, nausea, and vomiting or loss of appetite may be a sign of inflammation or infection of the gallbladder (acute cholecystitis).

What is the ideal treatment of gall stones?

If the stones in the gall bladder cause symptoms, then the best treatment is removal of the gall bladder. There is  no need to be on any special diet or any restricted activity after removal of gall bladder. Life is normal after surgery in the long run.

What will happen if I do not remove my diseased gall bladder?

If the gall bladder which is diseased with stones is not removed, then it can collect pus and become distended. The inflammation or infection from gall bladder can spread to the adjacent organs or the blood stream to cause septicemia.

The stones can come out of the gall bladder into the biliary tree to cause infection of the bile with jaundice, can cause pancreatitis or inflammation of the pancreas.

Sometimes the stones erode directly into the bile ducts or the bowel by an abnormal passage called internal fistula.

Occasionally in the elderly this can lead to or present as a manifestation of cancer of gall bladder.

What are the methods of gall bladder removal?

Gall bladder is removed surgically by open or laparoscopic method. Laparoscopy has replaced the open surgery and is referred to as the gold standard for removal of the gall bladder.

What are the advantages of laparoscopic Gall bladder removal ( cholecystectomy) over the open surgery?

Advantages of laparoscopy over open surgery are shorter stay in hospital, less  pain, less bleeding, less medication, early return to normal activity. Laparoscopy has replaced open surgery as the route of surgery.

 

What are the symptoms of appendicitis?

Appendicitis is an inflammation of the appendix, a two inch tubular structure which arises from the beginning of large intestine. Since no function is attributed to the appendix, one can live without it.

What is the treatment of appendicitis?

In mild cases, appendix is largely treated with antibiotics on a mistaken diagnosis. But where there is significant pain in the right lower abdomen ( after initial pain in the belly button) , the appendix needs to be removed surgically. If not, nasty infection sets in the abdomen which endangers life.

Once diagnosed with certainty, appendix is best removed by laparoscopic or open methods.

What are the advantages of Laparoscopy over Open surgery for appendicitis?

Laparoscopy allows surgeon to look at the interior of the abdomen and look for other causes similar to appendicitis. Also if there  is any other lesion seen at laparoscopy, it can be dealt with at the same time, like Meckel’s diverticulum or a twisted ovarian cyst in a woman.

Advantages of laparoscopy over open surgery are shorter stay in hospital, less  pain, less bleeding, less medication, early return to normal activity. Laparoscopy has replaced open surgery as the route of surgery, in advanced centres.

What is a hernia?

A hernia is a term which refers to a protrusion of tissue through a structure or part of an organ. The Latin word ‘hernia’ means “a rupture”.

What is groin hernia?

Groin hernia is a type of hernia ( as opposed to ventral or incisional hernia) which is commonly seen surgical disorder. It gives rise to a small swelling near the genitalia. The swelling becomes prominent on standing up or coughing. It reduces on lying down.

It may or may not give rise to pain. In advanced states, the hernia becomes painful and does not reduce in size even on lying down. When vomiting occurs with irreducible swelling, it is an emergency.

Groin hernia is commonly seen in men than in women.

What is incisional or ventral hernia?

Ventral hernia or hernia of the belly (abdomen) occurs more in females due to weak abdominal musculature or repeated child birth or previous operations. Ventral hernia also can occur as epigastric hernia with pain above the belly button.

It may have other associated fluid in the abdomen, constipation, urinary difficulty or chronic cough.

What is the treatment of hernia?

Treatment of hernia whether inguinal or incisional is always surgical. There is no medicine for hernia.

Patient should however have no illness which prevents anesthesia. Hernias can also be done using local infiltration on anesthetic drugs.

Surgery for hernia can be done by laparoscopic or open methods.

Anesthesia can be general or regional ( spinal or epidural) or local ( patient is awake and talking at the time of surgery).

Advantages of laparoscopy over open surgery are shorter stay in hospital, less  pain, less bleeding, less medication, early return to normal activity.  However compared to laparoscopic removal gall bladder, laparoscopic hernia surgery is considered a major procedure and is available in select centres only.

What is a mesh?

Mesh is a prosthetic material used to cover the hernia defect . This is not absorbable. This helps the tissues from the body to grow around it and form a mould to make the repair effective. It is made up of synthetic materials.

Mesh for the inguinal hernia is cheaper. For the ventral hernia, the mesh is more expensive in the laparoscopic repairs, as this mesh is multilayered.

Mesh may be sutured in place both in open and laparoscopic methods. In Laparoscopy if the surgeon is not trained, staples are easier to fix the mesh, but the staples are costly.

Can hernia recur after surgery?

Hernia occurs due to weak abdominal wall musculature. Hernias are usually well healed after surgery. However a small fraction will recur. These can be prevented by avoiding smoking, chronic cough, constipation, urinary defects, asthmatic attacks or excessive physical activity too early after surgery.

Which is better laparoscopy or open surgery for hernia?

Advantages of laparoscopy over open surgery are shorter stay in hospital, less  pain, less bleeding, less medication, early return to normal activity.  As for as the recurrence is concerned, there is no difference in both the methods. Most patients however prefer laparoscopy.

In laparoscopy, carbon dioxide is used under general anesthesia to create and maintain the space by which telescope is passed and surgery is done.

What is Obesity ?

Obesity is a condition in which excess body fat has increased to the extent that it may have a negative effect on health, leading to reduced life duration and/or increased health problems. People are considered obese when the body mass index is  (BMI) exceeds 30kg/m

How do you measure Obesity by international standards ?

Obesity is measured by  dividing a person’s weight by the square of the person’s height, exceeds 30 kg/m2 .

  • Any BMI ≥ 35 or 40 kg/m2 is severe obesity
  • A BMI of ≥ 35 kg/m2 and experiencing obesity-related health conditions or ≥40–44.9 kg/m2 is morbid obesity

A BMI of ≥ 45 or 50 kg/m2 is super obesity

What about Indian or Asian Measurements?

Indian measurements are 2.5 less than those of the international measurements with reference to the BMI.

What is Metabolic Syndrome?

Metabolic syndrome is a disorder of energy utilization and storage, diagnosed by three out of five of the following medical conditions: abdominal obesity, high blood pressure, high fasting plasma glucose, high serum triglycerides, and low high-density cholesterol (HDL) levels. Metabolic syndrome increases the risk of developing cardiovascular disease, particularly heart failure, and diabetes.

What are the causes of Obesity ?

Causes are excessive food intake, lack of physical activity, and genetics although a few cases are caused primarily by gene and endocrine disorders, drugs or psychological ailments. Some obese people eat little yet gain weight due to a slow metabolism and this is uncommon.

Generally obese people spend more energy than their thin counterparts as energy is required to maintain an increased body mass.

What are the dangers of being obese or overweight?

Obese people die earlier. Complications are due to associated

osteoarthritis, sleep apnea, social stigma, diabetes, hypertension, cardiac ischemia, cancer, non alcoholic fatty livers, hiatal hernia, gall stones, strokes, accidents, impotence, infertility and more.

How do you control obesity without surgery?

Dieting and physical exercise are the main form of treatment. Diet includes low fat, low carbohydrate, low calorie and very low calorie diets. Change in life style is important for sustained result.

Drugs to control overweight are Orlistat, Sibutramine which have significant side effects.

Who needs Obesity Surgery or Bariatric Surgery?

Surgery for severe obesity is associated with long-term weight loss and decreased overall mortality. A marked decrease in the risk of diabetes mellitus, heart disease and cancer has also been found after bariatric surgery.

Marked weight loss occurs during the first few months after surgery, and the loss is sustained in the long term unlike by non operative measures.

Surgery should be considered for those with BMI > 37.5

Surgery also for BMI > 32.5 with co morbid conditions such as Diabetes Mellitus, high BP, cardiac disease, sleep apnea, dyslipedemias and the such, who have failed to sustain weight loss by other measures.

How does  control of Obesity by surgery differ from Non surgical measures?

Non surgical measures may reduce weight by 3-5 Kg, but it is difficult to maintain this ; one tends to put back the weight in  a few weeks. After surgery, weight loss is permanent, profound and sustained over years. The high risk factors like sleep apnea, diabetes mellitus, hypertension, dylipidemias either completely subside or improve.

What are the types of bariatric or weight reduction surgery available?

All of obesity or bariatric surgery can be done using laparoscopic route. The common surgeries are:

Restrictive procedures, Malabsorptive procedures or Combined Procedures.

In restrictive surgery, the size of the stomach is reduced by either using a band or by removing the excess of stomach ( sleeve gastrectomy). In sleeve gastrectomy, a tube of the stomach is preserved allowing the hunger hormone (Grehlin) producing area to be removed. This results in a restricted stomach and less appetite.

In malabsorptive procedures such as Biliopancreatic diversion or duodenal switch , the small bowel is altered to make the mixing of digestive juices with the food at a much lower level than normal. This results in partial absorption of food ingredients resulting in weight loss.

In combined procedures such as Roux en Y Gastric Bypass (RYGB) and in Mini Gastric Bypass (MGB), the size of stomach is reduced to a much smaller shape and alteration of the small intestine is also done. Both restrictive and malabsorptive mechanisms are at play and there is marked weight reduction after surgery.

What are piles?

Pile are engorged, elongated and tortuous blood vessels in or around the anus and rectum. The involved vessels and veins are located in the lowest part of the rectum and the anus.

What symptoms do they produce?

Anal bleeding and pain of any sort can be main symptom. Sometimes one can get a prolapse of pile mass – which is a protrusion at the time of stools. These can be symptom of cancer of gut. So tests are required to rule out cancer.

What tests to do?

Examination by doctor with finger or  anoscope or a proctoscope or a colonoscope. Futher xrays with contrast of the intestines may be required.

When do I need surgery?

Initially medications like purgatives to relieve constipation, local anesthetics, pain killers may be required. Local bands maybe used with or without injections.

In significant advanced cases , surgery offers improvement.

What type of surgery?

Standard surgery of excision of pile mass can be done using regional anesthesia.

Stapler hemorrhoidectomy is the advancement now where the entire 360 degree of piles can be removed by surgery using a stapler gun.

What is Anal fistula ?

Anal fistula, or fistula-in-ano, is an abnormal connection between the epithelial surface of the anal canal and the exterior skin.

Anal fistulae originate from anal glands. These are located between the two layers of anal sphincters draining into anal canal. When the gland drainage gets blocked an abscess results forming a fistula.

What symptoms does it produce?

Local pain, anal discharge, swelling with pus and general symptoms of infection like fever, malaise can occur.

What tests to do?

Examination shows an external opening and sometimes internal opening also. The tract at least in some parts can be felt.

Investigations may be a fistulogram or a rectal ultra sound or MRI of anal canal as in the case of recurrent fistula.

When do I need surgery?

Generally most fistulas require surgery. One needs to make sure that there is no associated gut disease such as cancer or other disorders (IBS).

What type of surgery?

Generally laying open of the fistula tract is done. Small fistulas can be left alone if there is minimal symptom.

Specialized procedures like LIFT procedure is done for special fistulas. Videoscopic operations are also available for fistula in ano.

Glue therapy, advancement flaps or fibrin plug all have a role to play in surgery.

Does it recur?

There are at least 20 anal glands. For this reason anal fistulas can recur. Location of internal opening which is usually at the anal gland is vital at surgery. Excision of this completely results in good results. We have carried out 5 times recurrent fistulas with 5 external openings successfully after careful planning in a single surgery.

What is cancer?

Cancer is a group of diseases where there is unregulated cell growth. Cells grow without any inhibition. Cells grow into adjacent organs. Cells spread into remote parts of the body by blood or lymphatic stream.

The word tumor means growth and should not be confused with cancer. Tumor can be benign which does not spread like cancer. Tumor can be cancer when it spreads locally and also into other parts of body via the blood and lymphatic paths.

There are over 200 different known cancers that affect humans.

What are the common GI cancers?

Cancers of upper gastro intestinal (GI) tract include gullet (esophagus) or stomach. Cancers of the lower GI tract include those of colon and rectum.

How do you detect early cancer?

Cancer is suspected with minimal symptoms in the endemic areas. Clinical suspicion with aggressive testing like stools blood testing, endoscopy, colonoscopy with biopsy combined with clinical examination of the patient reveals early cancer of GI tract.

What are the symptoms of cancer?

Gastro intestinal (GI) tract ranges from mouth to the anus. Cancers of the upper gut may present with just loss of appetite, anemia, malaise or pain in upper abdomen.

Cancers of the lower gut may present with alteration of bowel habits ( diarrohea or constipation or combination of both), rectal bleeding, weight loss or abdominal swelling.

Frequently, cancer can be picked up on  routine testing without any symptoms.

Can cancer be cured?

Cancer of the GI tract is curable. The staging of the disease and the fact that it is localized without spread adds to the good results. Sometimes it is combined with chemotherapy or radiotherapy to achieve better results. Surgery however forms the main stay of GI tract tumors.

What is hydrocele?

Hydrocele is the swelling of scrotum in males due to the excess accumulation of fluid between the external coverings of the testis.

What anesthesia is used?

Local anesthesia is commonly used. In selected cases regional or even general anesthesia can be used.

What surgery is advised?

Initially one needs to rule out filarial worm as the cause of hydrocele in tropics. Once this is done or treated surgery is the main form of stay in moderate or large hydroceles.

Small hydroceles can be treated expectantly without any surgery.

Can I go home the same day?

Hydrocele surgery is the day care surgery where the patient goes home the same day provided there is someone to look after and a phone number is available.

What tests do I need for thyroid swelling?

A goitre is an enlarged whole thyroid gland. This gland may be normally active, underactive or overactive.

Goitre is diagnosed by physical examination. In some cases with one sided swelling, an ultra sound of neck is done to look for any small swellings in the other side.

A CT scan of the neck helps to look for associated lymph nodes in the neck or chest in suspected cases of cancer.

FNAC ( an aspiration biopsy) may help to diagnose if the thyroid swelling is an innocuous one or a cancerous swelling.

What are the disorders of thyroid swellings?

Thyroid swellings  can be one sided or both sided of the neck. Whole swelling of the thyroid gland is known as goiter which is generally due to iodine deficiency.

One sided swelling can be an innocuous goiter or a benign tumor or a cancerous growth.

What surgery is advised?

Removal of one half the thyroid is done for benign one sided lesion – hemithyroidectomy

Removal of both lobes of thyroid is done for bilateral swellings or cancer- Subtotal or total thyroidectomy.

Any recent development in surgery of thyroid?

Thyroid surgery is generally done by open surgery. Now we do minimal access surgery for thyroid by axilloscopy – insertion of telescope via the axilla and removal of thyroid with  no scar in the neck. A small incision via the front of the neck with telescope will help to remove both lobes of thyroid.

What are the complications of thyroid surgery?

Thryoid is a vascular organ. Hence bleeding is a complication along with infection. Specific to thyroid are the complications are voice change due to vocal cord involvement and hypo calcemia causing tetany due to parathyroid deficiency. Recurrence of the original disease can also occur is medication is not regularly taken.

Why do diabetics get ulcers in foot?

Diabetics are specifically prone for infection due to the disease per se. Also nerve weakness (neuropathy) causes loss of sensation of feet to trauma and heat paving way for ulcers in the feet. Loss of blood supply to feet by way of major vessel blocks or small vessel blocks can lead to ulceration. Infection spreads to bones easily in diabetics and this again gives rise to persistent discharge and tracts (sinuses)

How to prevent Diabetic ulcers in feet?

Prevention is by taking care of feet like face. Diabetic patient should take care of feet by inspection, wearing protective soft foot wear and periodic checkups. Regular blood sugar control is mandatory to achieve good results.

How to treat diabetic ulcers once you get them?

Dressing for the ulcers in the foot, antibiotics as indicated, rest of the foot, control of diabetes, testing of blood flow and nerves are all necessary. If the ulcer does not heal, a skin graft may be necessary for covering the ulcer to ensure good adequate early healing.

What are varicose veins?

Varicose veins are long tortuous distended veins usually in the legs. These occur due to failure of valves to prevent the backflow of blood from above down.

Varicose vein cause cosmetic concern. They can cause ache or pain on standing, swelling, ulceration or skin changes.

What are the complications of varicose veins?

Skin thickening ( lipodermatosclerosis), ulceration, eczema, bleeding, swelling of leg are all complications of varicose veins.

What is the treatment of varicose ulcer?

Generally stockings for legs and thigh in the standing position will suffice . If pain continues despite this and the ultra sound with color Doppler suggests facilities for correction, then surgery may be an alternate option.

What is varicose vein surgery?

Varicose vein surgery consists of disconnection of the veins in groin (Trendelenburg operation), stripping of varicose veins and avulsion excision of the branches.

Recurrent veins with perforator incompetence can be dealt by using an videoscope into the leg ( Subfacial Endoscopic Perforator Surgery) which is available at Anurag Hospital.

Any other treatment options?

SEPS  is a good option for recurrent veins with perforator leaks. Supportive stockings for the legs in the upright position, Sclerotherapy of injection method, foam therapy using ultra sound, Laser treatment for varicose veins are all options to surgery.

What are the causes of breast lumps?

Breast lumps are due to infections, trauma, non cancerous and cancer lesions.

What are the symptoms of breast cancer?

In  the early stages, breast cancer can present only on routine breast xrays. They can also present as painless lumps. When they become painful or ulcerated on the skin with swellings in the armpit, one needs immediate assessment and treatment.

In the advanced states, breast cancer will present with bone pains, lumps elsewhere, weight loss and symptoms of generalized weakness.

How do I know that my breast lump is not a cancer?

In addition to examination by doctor, the tests required are ultra sound examination of breasts (anyone less than 35 years), or mammogram ( age >35 years) are useful. Where there is a lump, a biopsy is useful in suspected cases. Biopsy may be fine needle or trucut or exision biopsy.

Is breast cancer curable?

Cancer of breast in the early stages is curable.  Treatment may consist of surgery and then chemo or radiation. Surgery is  in the form of wide excision of the lump ( preserving the breast) or mastectomy which is removal of the breast. This is decided on the local factors along with patient and spouse.

Is there surgery for reducing the size of male breast (gynecomastia)?

In young males, enlarged breast tissue can be distressing. This is called gynecomastia. In most cases, this responds to surgery by excising it with good cosmetic results

What surgery is available to reverse tubal sterilization operation?

Fibroids are the commonest uterine swellings in the child producing age of women. They occur in the uterus. They give rise to heavy bleeding and in between periods, heavy lower abdomen, backache, increased urination, infertility, miscarriage or early labor.

The treatment in young women expecting babies is to do laparoscopic myomectomy in which the fibroid is removed making the uterus of normal shape. This allows further pregnancies.

In the perimenopausal age where the patient has completed the family, laparoscopic hysterectomy may be contemplated.

What are the causes of infertility?

Inability to conceive or carry the term to full term is known as infertility. Causes may be due to male or female or both factors.

Male curable causes of infertility include varicocele which can be treated by laparoscopic varicocelectomy.

Female causes may be many. Local curable factors include endometriosis, polycystic disease of ovaries (PCOD), tubal blocks, uterine abnormalities and pelvic inflammatory disease.

All these local factors can be diagnosed with clinical examination and ultrasound. Laparoscopic method may be used in selected cases of endometriosis, PCOD and tubal blocks to improve fertility.

Even patients who have already undergone tubal ligation or sterilization operations can be reversed using laparoscopy.

What are the causes of heavy menstrual bleeding?

Causes of heavy menstrual bleed are many- generalized or localized causes. Dysfunctional uterine bleeding (DUB), or fibroids are usual causes. Generally the bleeding may be controlled with medication. If not, a D & C may be required to settle it and also to diagnose the cause.

Where the bleeding continues and if the patient is near menopausal age, laparoscopic hysterectomy maybe considered in selected cases for effective treatment.

What are the advantages of laparoscopic hysterectomy over the open removal of uterus?

Laparoscopic removal of uterus can be ‘Total laparoscopic hysterectomy’ or ‘Laparoscopic Assisted Vaginal Hysterectomy’.

Compared to open surgery, laparoscopic removal of uterus is associated with  less pain, less bleed, less medication, early recovery, early return to normal activity.

Also there is generally no urinary catheter or naso gastric tube  after surgery.

What are ovarian cysts?

Ovarian cyst is any collection of fluid surrounded by thin wall in an ovary. Most ovarian cysts are harmless occurring in child producing era of the woman. They may produce pain, bleeding, fullness or pressure.

When large and symptomatic, they can be removed very often using laparoscopic technique.

What surgery is available to reverse tubal sterilization operation?

If a woman who has undergone laparoscopic tubal ligations desires to have the operation revered for more children, this is immensely possible by laparoscopic surgery by freshening both the edges and fine sutures.

What are stones?

Stones in South India refer to urinary stones. The other stones which are common are Gall Stones.

What is the treatment of urinary stones?

Urinary stones occur in urinary tract and generally produce typically colicky pain with or without blood in urine. Urinary stones also can be silent.

Stones less than 7 mm in size pass on their own with increased drinking of fluids. Where the stones are larger or cause back pressure changes, they need to be surgically removed by endoscopic methods.

What is the treatment of gall stones?

Gall stones occur due to increased cholesterol content in bile or pigments in bile or as a reduced gall bladder function.

Symptomatic stones or with patients on immunosuppresants, the diseased gall bladder with stones is best removed by laparoscopy.

Laparoscopic cholecystectomy has now become the gold standard treatment of gall bladder disease.

Constipation is not a disease but a condition in which patient has less frequent stools per day. This results in hard stools which can cause ulceration and streaking of blood in stools with much pain called anal fissures.

This can give rise to bloated feel of the belly and distension called Irritable bowel syndrome. This also can have some diarrohea on and off.

Constipation can be the initial symptom of cancer of gut also. So this will need to be sorted out with tests.

Constipation is best avoided with taking lots of fluids, high residue,high fibre diet. More bran, more veggies, more fruits, regular exercise all go to avoid constipation and a positive outlook in life.

Why circumcision?

Removal of the excess foreskin of penis in boys or men is circumcision.

Circumcision is ritual in the Jews and muslims. Medically it is indicated if the prepuce is narrowing the urinary passage causing urinary infections.

What anesthesia?

In young children, general anesthesia.

In informed men, it can be local, regional or general anesthesia

How long should I stay?

Usually patient can return the same day if surgery is done in the morning.

In other cases or as in insurance patients, home the next day.

When should I get admitted?

This is generally on the morning of surgery or the previous night as discussed with the doctor.

What should I bring with me?

You need to bring in the list of medicines as well as the medicines  you are now using, with you to the hospital. You also need to bring in a list of allergic medicines and clearly mention this to the doctor as well as the nurses who will write this down on the chart.

You need to bring in your insurance details with you including the card.

For elective cases with insurance, the permission would have been obtained.

If not, clearly mention this at the time of admission.

A computerized bill will be given to you for all your payments for claiming the money.

You need to bring your bed clothes. You can purchase the toothpaste, brush and personnel things at the hospital.

Who should I bring with me?

 Bring a responsible attendant – a relative or friend with you to be around at time of surgery.

Any child should be accompanied by parents or legal guardian who will need to sign the informed consent form.

Can I drive back after surgery?

No, you cannot.

Driving back after general anesthesia or even local anesthesia is not advised. Have a relative to give you a lift.

Autos and taxis are available. Hospital staff will provide this service.