Preoperative Evaluation

After a patient receives a recommendation for surgery, he or she understandably will have many questions. 

These and many other questions will be answered in the preoperative evaluation and planning session.

The preoperative evaluation, conducted by physician assistant Lisa Frantz, is usually scheduled as a separate office appointment after a patient has been indicated for surgery.  This gives the patient an opportunity to formulate his or her questions and to include family members in the preoperative planning session if they choose to do so. 

The purpose of our preoperative evaluation is to assure that each patient is as well prepared for the planned procedure as possible.  The essential features of the preoperative evaluation are as follows:

Each of these is described in more detail below.

Review of Treatment Options

Patients are educated regarding the diagnosis (clinical problem) and the surgical treatment (proposed solution).  Visual aids, including plastic models of the affected body part, may be used during this discussion.  Likelihood of successful outcome and anticipated recovery time are estimated.  Alternative nonoperative and surgical treatment options are discussed.  If the patient has reservations regarding the proposed surgery, then he or she is encouraged to obtain a second opinion from another health care provider before proceeding with the scheduling process.

General Medical Screening

The patient’s past medical history, particularly with respect to heart or lung problems, is reviewed in detail.  A general physical examination is accomplished.  Those patients with prior heart or lung problems may be asked to see their family practice specialist or cardiologist in order to have a risk assessment for general anesthesia.  The medical specialist may require the patient to have further testing, such as EKG, cardiac stress test or echocardiogram, before the planned surgery.  In such cases, the patient may not be scheduled for surgery until medical clearance is obtained.

Informed Consent

The focal point of any preoperative evaluation is the informed consent process.  Patients must understand the perceived benefits and potential complications of the proposed procedure.  In most cases, patients are required to view a short 8 to 10 minute video on the procedure.  The video contains comprehensive information regarding the planned surgery, including expected outcome and anticipated risks.  Expectations regarding the immediate postoperative period, including the need for physical therapy, are established.  Patient and family members are given an opportunity to ask questions.  When all questions have been addressed, the patient signs the consent form, confirming the informed consent process is complete.

Surgery Scheduling

As the preoperative office visit is completed, most patients are given the date and time of surgery.  In some cases, patients will be notified by telephone when the surgery has been scheduled.  All procedures are done at the Kansas Surgery and Recovery Center (KSRC) which is located next to our office.  First postoperative office appointment is also scheduled at this time.  Patients should notify medical assistant Sheri Nebergall (316-631-1600 ext 338) immediately if circumstances require a planned surgery to be rescheduled or cancelled.

Preoperative Instructions

Patients are then given verbal and/or written preoperative instructions by the physician assistant.  Anti-inflammatory medicines and certain herbal remedies should be discontinued one week prior to surgery.  Patients should fast for 8 to 12 hours before surgery.  Some medicines may be taken with a sip of water on the morning of surgery.  Patients are given a KSRC information pamphlet describing what to expect on the day of surgery.  Most procedures are done on an outpatient basis which allows patients to return home after surgery when they have recovered from anesthesia.  Other patients, however, may require overnight stay at the surgery center.  All of these details will be discussed at the preoperative planning session.

If new questions arise after the preoperative appointment, then patients are encouraged to call our office, so that all questions or concerns may be addressed prior to surgery.