This is how my surgery day went. Yours may be similar or different. Every case of prostate cancer is unique.
SURGERY DAY – My da Vinci robotic surgery is scheduled for 7:30 am, so I was told to arrive by 6:00am.
Nurse’s first prep me in a small, curtained off area, insert IV’s in both arms, because they want to use one in the operating room and one for backup. They take more blood samples.
White-compression socks are put on my lower legs to help prevent blood clotting.
I had used the Hibiclens® antiseptic cleanser in the shower at home. Don’t have to scrub hard, just make contact with the skin. Then at the hospital, a staff person gave me what I think was a betadine-soaked antiseptic towel that I was supposed to rub on my torso (chest to groin area) for 3 minutes to further sanitize the area.
The anesthesiologist assigned to my surgery stopped by to meet with me & ask questions about allergies, loose teeth, etc. My urologist-surgeon stopped by as well and asked if I had slept well last night. I said as a matter of fact I did. It was two nights ago that I couldn’t sleep, so last night I was zonked out.
Then an operating room nurse came by to wheel me over to the O.R. She says I will be shaving your groin area, and you will be itchy in about 3 days, so blame me. (I was never very itchy, though.) Click here for my post on… Should I shave my groin before prostate surgery? The O.R. nurse tells me that she (and her team) will take about 40 minutes to prep me before the doctors get started. Then the doctors take about 2 hours. Then recovery room is 1 to 1.5 hrs, followed by transport to my room.
When they wheel you into the operating room, you can see the da Vinci setup – the console where the surgeon sits is about 10 feet away from where the patient lies. I was looking for the da Vinci robot itself (patient side cart), which was retracted up and away from the operating table and tucked up into a corner of the room, kind of up high near the ceiling, with plastic covering up most of the device and its protruding arms or laparoscopes.
I had been drinking the bowel prep solution starting @ 8:00 am the previous day, and I was still rumbling down there, so I thought, what if I “soil” or mess the operating room table? But as I was scooting myself over from the gurney and onto the OR table, the nurses took a lot of time to position me right over a break or opening in the 2 pieces of the platform you lie on. Basically there’s a big opening there where they must collect or trap any bowel fluids that come out while under anesthesia. Maybe that’s why they had me start the bowel cleanse at 8:00 am the previous day – to minimize this possible leaking.
The anesthesiologist said, “I am starting the cocktail,” and that’s the last thing I remember.
So I wake up in recovery and I wonder to myself, what happened, how did it go?
As I regain consciousness, I wonder how much of my insides have been cut out, what was saved, what was spared. There is no way of knowing just lying there. I don’t really feel too much pain, I certainly don’t feel like I just had major surgery. (Click for my post Is there pain after da Vinci Surgery) All I feel is foggy-groggy from the anesthesia.
Also I noticed when looking at my abdomen, the 5 or so keyholes where the da Vinci robot inserted its instruments were merely black and blue marks with no other signs that there had been an incision. No bandages, no steri-strips, nothing. How could they have closed so fast and so completely?
Doc told my wife in the consultation room afterwards that the surgery went well. He was able to spare both nerve bundles (left and right).
Later, I found out after reading my post surgery pathology report, where they have the whole organ to examine, that – in addition to my prostate gland – my doc also removed both seminal vesicles, (L and R) and parts of both Vas Deferens. I believe this is fairly common.
Now in my room, gradually as the anesthesia wore off, I began to feel some achiness in my stomach area. Actually I believe there were 2 things happening, a) pain from the small incision in my belly button, which feels like the day after you do a thousand sit ups, and b) the gassy/bloated feeling probably caused by the CO2 they injected in my abdominal area during robotic surgery.
All of this is no doubt one helluva lot less pain and discomfort than a 5″ incision in my groin would have been, so let’s put this in perspective. It’s really not that bad.
That whole first day and for much of the second, until I passed gas, I had this overall achiness in my stomach area, but it’s not anything to really complain about. You feel it mostly when you try to scooch yourself up to watch TV or eat dinner, or should I say “drink” your dinner – no solid foods today – just tea, consommé, broth, jello, juice & water.
On the 2nd day, I was able to pass gas, and that part of the belly ache felt a lot better. Then you’re another day after surgery and the belly-button incision pain is subsiding too. In about 3-4 days, I had almost no pain at all – an unbelievably short period of time, if you ask me.
On the abdominal pain from the belly button incision, it hurts when you laugh or sneeze. So if you get hospital visits from family or loved ones, and they try to make you laugh, it hurts. And ironically, now that you don’t want to laugh, everything sounds funnier than usual.
I also felt a soreness in my throat – probably because the anesthesiologist put a breathing tube in my mouth and down my throat.
Nurses took my vitals every few hours or so, day and night.
I have these inflatable jacketed things that are attached with Velcro to my lower legs that inflate and deflate in rhythmic fashion. I believe they’re called “intermittent pneumatic compression” devices – supposed to help prevent blood clots.
The docs have left a catheter installed during the surgery …” a catheter is left in the urethra and is connected to a drainage bag. This is used to align the suture line for the bladder and urethra connection, and drain the bladder…” (source: http://www.robotic-prostatectomy.com/faq#prostatectomy)
Oddly, the pain in my stomach area seemed to radiate up into my shoulder area as well. So when I would scooch up to eat a meal (or drink a meal), I would feel some minor pain in my shoulder area too. Some posters in online forums suggest that this shoulder pain might be due to somehow being “inverted” for the da Vinci surgery. I don’t know if that’s true or not.
The doctor left a JP Drain (Jackson-Pratt) in my abdomen that drains blood from the surgical area – it’s a pretty small 100 cc reservoir bulb-thing, and it works by suctioning up excess fluids. Normally this drain is removed the next day, or one day after surgery.
In the scheme of things, and especially as compared to what “open surgery” must be like, this was a walk in the park. I was offered pain medication at every juncture, but never needed it nor accepted it once, either while I was in the hospital or at home. And I was not trying to be a hero.
I spent the afternoon in my private room on Tuesday with the nurses giving me great care, checking vitals, asking if I needed anything, changing out IV’s when empty, etc.
My doctor told me earlier that “…we let you rest on the day of surgery, but we get you up on Day 2…” So I said, I’m going to walk on Day 1, what the heck. So about 3:00 pm or so, I asked the nurse on duty if she could get me up for a short walk, and she agreed. (See how I got up and walked 3 hours after da Vinci surgery)
First, she had to take off those compression do-hickies on my lower legs, then unplug my IV drip stand from the wall (to go on battery) and away we went down the hall. Not very far, I mean I didn’t feel like doing all that much to be honest, but it felt good to walk a little, then back into the hospital bed.
That evening, I received a visit from my GP or general practitioner.
I was also given a clear plastic device-thing that I was supposed to occasionally inhale to make the plastic balls rise to the top. Do it every so often, as a method to protect against pneumonia. I believe this was called an Incentive Spirometer.
Frankly, you don’t sleep well in a new place the 1st night even under the best of circumstances. You basically sleep in fits and starts. Sleep for a couple hours, then you’re awake for an hour etc., then sleep for another 2 hrs. I didn’t know I could “close my door” or partially close my door to dampen the noise, but I did do that on the 2nd night in the hospital.
Click here for One Day After Radical Prostatectomy Surgery.
Click here for One Week Before Prostate Surgery.
Click here for One Day Before Prostate Surgery.