BEFORE THE CARDIOMYOTOMY OPERATION FOR ACHALASIA
If your doctor has recommended Robotic Esophageal Achalasia Repair, you should follow some simple instructions to make the surgery process easier. Make sure you complete the pre-operative check-up recommended by your doctor:
PRE-OPERATIVE WORKUP OF KINETIC DISORDERS OF THE ESOPHAGUS - ACHALASIA:
- GASTROSCOPY
- ESOPHAGEAL MANOMETRY
- PLAIN CHEST X-RAY (WITH HAMI-DIAPHRAGM) F/P
- ESOPHAGUS READING WITH BARIUM SWALLOWING
- ABDOMINAL ULTRASOUND
In clear cases of esophageal achalasia, gastroscopy, esophageal-stomach passage with barium and upper abdominal ultrasound are sufficient for preoperative planning, while in more complex cases (e.g. in case of unclear diagnosis, coexistence of GERD, multiple endoscopic dilatations, recurrences after previous surgery etc), Dr. Chirides may recommend more tests, such as 24-hour pHmetry, esophageal manometry, and/or CT scan of the chest, upper abdomen.
Confirm the Operation Date and if in doubt check the Admission Paper or contact the doctor's Secretariat for any clarification. The night before surgery make sure you go to bed early after a relaxing bath and light dinner. Take care of your adequate and full hydration one day before the operation. It is best not to eat or drink anything after midnight. You must fast for at least 6-8 hours before surgery. If you are taking medication, you will normally continue your treatment with some water until the morning of the operation. If you are taking anticoagulants or aspirin and have not stopped them, contact your doctor. Be informed at least 72 hours in advance of current pandemic prevention guidelines to allow admission to the hospital. If you wish to have the Covid test included in your hospitalization package, you must visit the hospital at least 24-48 hours before your admission, and provide a sample.
On the day of the operation you will come to the Movement Office, usually early in the morning (8am) to be admitted to the hospital. It is a good idea to have all your insurance-related forms, booklets and ID with you. In the outpatient clinics, the standard pre-operative examinations will be performed:
- general blood
- biochemical blood tests (sodium, potassium, sugar, urea, creatinine)
- coagulation test (APTT, INR)
- chest X-ray
- and electrocardiogram
Don't forget to take all your recent tests with you, especially those related to the operation (gastroscopy, barium pass). Once the pre-operative check-up in the outpatient clinics is over, you will go up to the room. There the medical assistants will take your history and you will be examined by a cardiologist and an anesthesiologist. Remember to mention any chronic conditions, previous surgeries and definitely any drug allergies. You will then be given elastic protective stockings and a surgical gown. Once you are ready, you will be taken to the operating room. The head of surgery and the anesthesiologist will be waiting for you there, who will guide you through the anesthesia process. Again discuss the exact diagnosis, location of the problem and the operation you will undergo. Again remember to mention if you have a history of surgery or drug allergies.