INFORMATION FOR YOUR GYNAECOLOGICAL OPERATION

Dr Cario has recommended that you have an operation performed. There are a number of important steps in your surgical journey that are extremely important .You must consider these before your operation. His Practice Theatre and Peri operative Nursing Sister will help you through each stage.

1 Why? How? What Next?

Dr Cario will have explained to you why you require this procedure and in basic terms outlined the operation itself, the risks of complications and the postoperative pathways that he expects you to travel along to a successful conclusion to your operation. In most cases he will have supplied you with information sheets that will assist in understanding these matters. It is absolutely vital that you read all of this information and have asked the appropriate questions to satisfy yourself completely. If you have further questions or worries discuss these with sister or she will arrange for you to be scheduled a further preoperative consultation with Dr Cario

2. The Consent.

This must be signed preoperatively with confidence and it is your responsibility to make sure you know exactly all the issues surrounding your operation as we discussed above.

3. Who is doing the operation?

As a private patient you have a contract with Dr Cario for him to carry out the operation himself and undertake your care personally. Public hospital or medicare  patients are admitted  under and cared for by Dr Cario’s team of residents and registrars. In general their operations will be undertaken by surgeons at various stages of their training under his supervision. In particular they will look after you postoperatively but you will return to Dr Cario’s rooms for your postoperative follow up care. It is very important for you to understand this difference and discuss it with Sister or Dr Cario if it causes you any anxiety.

4. Where will my operation be done?

Your operation will be done at Hurstville Community Calvary Private Hospital or St George Private Hospital for private patients and St George Public Hospital for medicare public patients.

Hurstville Community Hospital
37 Gloucester Road
Hurstville, NSW 2220
(02) 9570 5777

St. George Private Hospital
1 South Street
Kogarah, NSW 2217
(02) 9598 5555

Macauarie University Private Hospita

2 Technology place

Macquarie University Ryde NSW 2109

(02) 98878899

St George Hospital

Gray Street

Kogarah,NSW 2217

(02) 9350 1111

5. What preoperative tests and preparation do I require? Sister will outline the blood tests and investigations that will be needed and also the preparation for the day of your surgery which may include special bowel preparation and diet especially for advanced Laparoscopic operations. She will tell you when to stop all food and drink on the day of your operation.

6. What about all my medications?

Please tell Dr Cario and sister about ALL the drugs that you take. In particular it is important to discuss Aspirin, Warfarin and any drugs that thin the blood as these have to be stopped around 1 week prior to surgery and be restarted after your operation according to special rules. We also need to know about antidepressants and major tranquilising drugs.

7. What about my anaesthetic?

As a private patient your anaesthetic will be undertaken by Dr Cario’s very experienced specialist anaesthetist. In the public hospital the anaesthetic is undertaken by the registrar in training under supervision from the hospital team. It is essential that you discuss your entire past medical, surgical, anaesthetic and drug history with them at your preoperative visit.

8. What is the cost of the operation and how will my hospital costs be met?

Sister will give you a complete run down on all of the costs from Dr Cario including the amount paid for by the fund, medicare and your out of pocket expenses. Sister will explain to you how the out of pocket expenses have to be paid for prior to or on the day of surgery. In general Dr Cario charges the fees according to guidelines suggested by the Australian Medical Association and the National Association of Obstetricians and Gynaecologists. The Medicare rebate has long been abandoned by specialists as it has never reflected the degree of difficulty of today’s surgery, has no component to redress the outrageous medicolegal costs born by today’s surgeons and has never even tried to keep pace with inflation or the CPI. Sister will also attempt to give an estimate of the anaesthetists out of pocket fees.

Patients with private insurance usually have no out of pocket HOSPITAL expenses. Patients who are self funded and not in a fund will get a fairly accurate estimate of the individual hospitals out of pocket fees that will have to be paid on admission to hospital.

9. What happens on the day of operation?

You will be admitted a number of hours before your scheduled operation with the appropriate fasting which is usually at least 6 hours without food or drink. You will be taken to the holding bay in theatres and Dr Cario or his registrar in the public hospital will once again make sure you understand your operation and discuss any last minute questions you may have. In the private hospital Our Practise Theatre and Peri operative Sister who will be known to you will already be preparing for your operation and will make sure you feel as comfortable as possible when you enter the theatre. Please note that it is impossible to accurately predict the actual time you will have your operation as sometimes prior cases become more complicated than expected and of course Dr Cario is still actively involved in Obstetrics which in an emergency setting always takes priority over elective surgery. Please be patient and be assured that Dr Cario rarely postpones surgery to another day and will perform your surgery even if that means working well into the night

10. After the operation in hospital?

Dr Cario (usually) or sister or sometimes one of Dr Cario’s colleagues or Research fellows will see you on rounds after the operation and answer all your questions regarding your operation and postoperative progress until your discharge from hospital. Day surgery patients are usually seen in recovery before being taken back to the day ward by Dr Cario unless the procedure is minor when there will be no new information until the pathology results are available in the rooms. You will not be discharged until you are travelling along one of our normal postoperative pathways. This time comes when there is no further active care given by the doctor or the Nursing staff. Convalescing or rest and recuperation is always done at home in modern hospital management.

PLEASE READ THE POSTOPERATIVE SECTION OF YOUR INFORMATION BROCHURES OVER AND OVER AGAIN

11. After the operation at home?

You will be given Sisters Emergency Mobile Phone Number for use after discharge particularly for use over the first weekend following your operation. This is for urgent contact only. If your enquiry is not urgent then it is best to ring my rooms on the next working day to leave a message so that Sister can return your call. You may also call your hospital ward 24 hours a day for an urgent enquiry or your own referring GP. Please do not suffer in Silence. Sister will usually contact you by phone from our office a few days after your operation to confirm that you are travelling along our normal pathway. She will also book your postoperative visit to see Dr Cario in the rooms.

12. Your postoperative Kit?

This includes iodine wipes for cleaning your operation sites or port sites (usually small 5-10mm cuts in the skin  that are closed with under the skin dissolvable stitches that don’t require removal as shown in the brochure).It also has pain relief medication consisting of Panadol, Nurofen and Voltaren suppositories for various levels of pain relief with the instructions for use.

13. My final postoperative visit?

Dr Cario will discuss all the details of your operation and may have some photos of your keyhole operation to help him explain this to you. He will usually examine you except with minor procedures to make sure he is happy with the final result. He will also give you all your pathology results and answer any of your questions. He will also outline all of your follow up management in full.

Please note that a copy of all the main brochures on:

LAPAROSCOPIC and Robotic HYSTERECTOMY

LAPAROSCOPIC INCONTINENCE SURGERY

LAPAROSCOPIC PELVIC FLOOR RECONSTRUCTION

VAGINAL SURGERY AND PELVIC FLOOR RECONSTRUCTION