Anti Reflux Laparoscopy Surgery

PreOp.com The Patient Education & Patient Engagement Company

What is Anti-Reflux Laparoscopy Surgery?

When you have acid reflux disease, the weakened muscle allows the contents of your stomach to back up into your esophagus, causing a considerable amount of discomfort, with symptoms like heartburn, difficulty swallowing, chest pain and belching.

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Your doctor has recommended that you undergo surgery to treat reflux disease. But what does that actually mean?

Your diaphragm is a muscle that separates your chest from your abdomen and helps you to breathe. Normally, the diaphragm has an opening for the esophagus to pass through where it connects with the stomach.

At this point, the ring-like layer of muscle which acts as a one-way valve sometimes becomes lax.

When you have reflux disease, the weakened muscle allows the contents of your stomach to back up into your esophagus.

Patient Education

This can cause considerable discomfort, often worse at night, with symptoms like heartburn, difficulty swallowing, chest pain and belching.

Reflux disease is often caused by a hiatal hernia, pregnancy, an ulcer or tumor of the esophagus.

About half of the patients with severe Reflux Disease often have a hiatal hernia, which is a tear in the diaphragm.

Your Procedure:

On the day of your operation, you will be asked to put on a surgical gown.

You may receive a sedative by mouth and an intravenous line may be put in.

You will then be transferred to the operating table.

The anesthesiologist will begin to administer anesthesia - most probably general anesthesia.

The surgeon will then apply antiseptic solution to the skin around the area where the incisions will be made, place a sterile drape around the operative site.

After allowing a few minutes for the anesthetic to take effect a small incision is made above the umbilicus; then, a hollow needle will be inserted through the abdominal wall.

And the abdomen will be inflated with carbon dioxide.

An umbilical port is created for the laparoscope.

Four more incisions will be made, with care taken to keep the openings as small as possible.

Once in place, the laparoscope will provide video images, so the surgeon can insert the instruments used to locate and pull back the liver in order to see the upper part of the stomach.

Then, the surgeon cuts away the tissue that connects the liver and the stomach.

Then the surgeon divides and separates the arteries that supply blood to the top of the stomach.

After freeing the stomach from the spleen, your doctor wraps the upper portion of the stomach around the esophagus and sutures it into place.

A rubber tube is placed in the esophagus to keep the wrap from becoming too tight.

All of the instruments are withdrawn the carbon dioxide is allowed to escape the muscle layers and other tissues are sewn together and the skin is closed with sutures or staples.

Finally, sterile dressings are applied.

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Diagnostic Cardiac Catheterization - PreOp® Patient Engagement and Patient Education

PreOp® Diagnostic Cardiac Catheterization

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Your doctor has recommended a cardiac catheterization, also called a cardiac cath.  It is a procedure to examine your heart.

This video will help you to understand this procedure. Let’s begin by reviewing information about your body.

Your heart is in the middle of your chest under your ribs.

It is the muscle that pumps blood to the rest of your body. Blood flows through tubes called blood vessels.

Arteries are strong blood vessels that carry blood away from the heart to the body. The aorta is the largest artery in the body and the blood it carries is rich with oxygen.  

Veins are a different type of blood vessel that carry blood back to the heart. The vena cava is the largest vein in the body.  It carries oxygen poor blood back to the heart.

During a cardiac cath your cardiologist can test how well your heart muscle is working. 

The arteries that carry oxygen to the heart are examined and blocked arteries can be identified.

The inside of the heart, the walls and important flaps called valves are checked for problems.  

To do a cardiac cath, a cardiologist places a thin tube called a catheter through an artery in your leg or arm to reach your heart. 

The Femoral artery in the leg is most commonly used.  The catheter is inserted into the artery in the groin then guided to reach the heart.

The radial artery in the arm is another site that a catheter can be placed.  The catheter is inserted at the wrist then guided to reach the heart. 

Which artery is selected for the procedure depends on your personal situation, and the experience and training of your Cardiologist.

A contrast dye that can be seen with an x-ray machine is given.  X-ray pictures and video of the dye show the cardiologist how blood is moving through your heart.

For your cardiac catheterization procedure you will be positioned carefully on an x-ray table.

The skin over an artery of your leg or arm is cleaned, then numbed with local anesthetic. 

You will feel a sting and burn that lasts only a few seconds.

A tiny cut is made over the artery, and a guide for the catheter is placed.  You may feel pressure but you should not feel pain.

Next the long catheter is threaded through the guide in your artery, up to your heart.

Dye is given through the catheter and the X-ray camera is used to see it flow through the heart.

The arteries that feed oxygen to your heart, the inside walls and the shape of your heart are examined. 

After all the necessary pictures have been taken.  The catheter is carefully removed from the artery.

Gentle pressure, a stitch, a patch or a plug is used to prevent bleeding from the artery.

The incision is covered with a dressing.

After the procedure “speak-up” and tell your care-team if you have more than expected pain or problems.

This is a common, minimally invasive procedure.  Serious problems can happen but rarely. There is a risk of having a reaction to the dye, bleeding, damage to an artery or the heart, stroke, heart attack, and even death.

That is why you are monitored closely during and after the procedure. You can help by telling the staff about any problems you are having.

If your leg artery was used for the catheter, you must lie flat for up to 6 hours after the procedure to prevent bleeding from the site.

How long you must lie flat depends on how the artery was sealed.   If the artery is patched or plugged you may be able to move sooner. 

The next steps for your care will depend on what was found during the procedure and your general health.

At the catheter site mild soreness and bruising is normal. Rarely bleeding or infection can happen.  Help prevent problems by following your doctor’s instructions carefully.

The first week after the procedure rest as needed. Do not exercise or lift anything more than 10 pounds. 

Wear loose clothes and do not swim or soak in a tub.

Keep your incision clean. Remove the dressing as listed in your instructions.  Wash gently and pat dry every day. And do not rub the incision.

You may be asked to drink extra water and/or other liquids to help your kidneys flush the contrast dye from your body.  What to drink and how much to drink will be different for you if you have diabetes, heart failure, or kidney disease.

 Call your doctor if you have a fever, swelling or redness at your incision site, worsening pain, or any bleeding that doesn’t stop.

Hospital admission, medication or surgery may be needed to fix some problems. 

You will be scheduled for a follow-up appointment  to discuss your  results and to have your incision site examined.

To avoid cancellation or complications from anesthesia or your procedure, your Job as the Patient is to    

not eat, drink or chew gum after midnight, the night before the procedure unless you are given different instructions

take medications you were told to on the morning of the procedure with a sip of water

follow instructions about aspirin and blood thinners before surgery,  you may be asked to stop taking them or continue taking depending on your situation,

and arrive on time

You should be ready to verify or confirm your list of medical problems and surgeries, all of your  medications, including vitamins and supplements, your current smoking, alcohol and drug use and all allergies, especially to medications, latex and tape.

Before you have this procedure it is your job to speak up and ask if you still have questions about why it is recommended for you, the risks and alternatives.  Also understand the risk of not having the procedure.

This video is intended as a tool to help you to better understand the procedure that you are scheduled to have or are considering.  It is not intended to replace any discussion, decision making or advice of your physician. 

PreOp® Diagnostic Cardiac Catheterization

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What is Cardiac Catheterization?

A Cardiac Catheterization is a procedure to examine your heart. The arteries that carry oxygen to the heart are examined and blocked arteries can be identified. Arteries are strong blood vessels that carry blood away from the heart to the body. The aorta is the largest artery in the body and the blood it carries is rich with oxygen.

#Cardiaccatheterization #CoronaryArtery #cardiovascular #Heart #Cardiology #Cardiac #Catherization

Laparoscopic Radical Prostatectomy Surgery • Patient Education & Patient Engagement

The PreOp® Laparoscopic Radical Prostatectomy Surgery • Patient Education & Patient Engagement --- https://preop.com/



Your doctor has recommended a procedure, Laparoscopic Radical Prostatectomy to treat your prostate cancer.



Before we talk about the procedure, let’s review some information about the prostate and your medical condition.



The prostate is located under the bladder and behind the penis.



It is a walnut-sized gland that is part of the male reproductive system. It helps make semen.

      The Urethra is a tube that carries both urine and semen to the penis.  It passes through the prostate which surrounds it like a donut.



Prostate cancer is the second most common cancer in men. It usually occurs in men age 50 and older and those men that have a family history, especially a father or brother with prostate cancer. But the highest risk is for men that are African American and over age 70



The treatment of your cancer will depend on many factors including the size, spread and type of cancer, your age and health.



The options that you may have considered are watch and wait, medication including hormones, radiation therapy and/or surgery.

It is very important that you understand why this surgery has been recommended for you.  If you have questions, ask.



Radical Prostatectomy is surgery to remove the whole prostate gland, some nearby tissue and lymph nodes.  Everything removed is tested to be sure the cancer has not spread.



This surgery is only used as a treatment if the prostate cancer is still in the prostate.  If the cancer has already spread, then surgery does not help and can cause serious problems when other treatments are used.



 In fact, if during surgery, the surgeon finds that the cancer has already spread and is outside of the prostate, the procedure is stopped and other more effective treatments for the situation are planned.



There are different ways to operate and remove a cancerous prostate.  Your surgeon has recommended a laparoscopic surgical procedure.   

A long instrument with a light and camera, called a laparoscope is used.  The scope makes it possible for your surgeon to see and operate on hard to reach, delicate tissue.



This is minimally invasive surgery that uses very small incisions instead of a classic large incision.  Healing and return to normal activity is usually faster with less bleeding and fewer complications.

With all laparoscopic procedures, the surgical team is prepared to change your surgery to an open procedure with a larger incision if this becomes necessary.  An open procedure is sometimes needed to treat unexpected bleeding or other findings during a procedure that make it impossible to do using a laparoscope.  If this happens your stay in the hospital and recovery will be longer than you originally expected.

Be sure you understand why a laparoscopy has been recommended for you.

What is  Laparoscopic Radical Prostatectomy to treat your prostate cancer?

The prostate is located under the bladder and behind the penis.

It is a walnut-sized gland that is part of the male reproductive system. It helps make semen. The Urethra is a tube that carries both urine and semen to the penis.  It passes through the prostate which surrounds it like a donut... 

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#prostatectomy #prostatecancer #Incontinence #prostate #urology

PreOp® RTUP, Resección Transuretral de próstata Cirugía

RTUP, Resección Transuretral de próstata Cirugía



Su médico ha recomendado que se trate su próstata con una RTUP, o Resección transuretral de próstata.

Antes de hablar sobre este procedimiento, vamos a repasar un poco de información sobre la próstata y su condición médica.



La próstata se ubica debajo de la vejiga y atrás del pene.

Es una glándula del tamaño de una nuez que forma parte del sistema reproductor masculino. Ayuda a hacer el semen.

La uretra es un tubo que lleva tanto la orina como el semen al pene.  Pasa por la próstata que lo rodea como una rosquilla.

En algunos hombres la glándula prostática se agranda y obstruye la vejiga al apretarla o crecer hacia la uretra.

HBP - o Hiperplasia benigna prostática,



es la razón más común del agrandamiento de la próstata en hombres mayores de 50 años,

no es cáncer,

la HBP puede causar una obstrucción llamada Obstrucción de la salida de la vejiga o BOO, por sus siglas en inglés



Los síntomas del agrandamiento de la próstata son: 

vaciamiento incompleto de la vejiga o ser incapaz de vaciar la vejiga completamente

frecuencia, la necesidad de orinar de forma seguida

intermitencia, iniciar y parar varias veces durante la micción

urgencia, sensación fuerte de "tener que ir al baño"

flujo urinario débil, o goteo

pujo para vaciar la vejiga

y nocturia, orinar frecuentemente en la noche



Ahora hablemos sobre el procedimiento de RTUP

El cirujano utiliza un instrumento con una luz y una cámara, llamado endoscopio.  Tiene un asa en la punta que puede cortar con energía de calor.



El cirujano guía el asa para extirpar el tejido prostático que ha crecido hacia adentro para comprimir u obstruir la uretra.



Este procedimiento se emplea con la intención de aliviar sus síntomas al remover la obstrucción.

El tejido que se extirpa de la próstata se manda al laboratorio para hacer pruebas.

Ahora hablemos un poco más sobre lo que sucede durante una RTUP.



Antes de empezar la RTUP le dan anestesia general para dormirlo y mantenerlo libre de dolor durante el procedimiento.  Con cuidado, lo ponen en la posición indicada.

Un instrumento con una luz y una cámara, llamado el endoscopio, se introduce cuidadosamente adentro de la uretra.



Se utiliza un gel anestésico para que el endoscopio se deslice fácilmente.

El cirujano utiliza el endoscopio para alcanzar la próstata y ver el tejido prostático que está causando la obstrucción.

La misma asa se utiliza para quemar y detener cualquier sangrado que se observe.

Cuando se termina la cirugía, se remueve el endoscopio.



Su cirujano le colocará una sonda de Foley para ayudar a drenar su orina por unos días.



Una sonda de Foley es un tubo delgado que se introduce por la uretra y hasta su vejiga. 

 

El tubo mantendrá la vejiga vacía y permitirá que se sane y se sienta más cómodo. 

La sonda de Foley se remueve fácilmente unos días después del procedimiento.



El globo se desinfla y el tubo simplemente se desliza hacia afuera.



Debido a que se extirpa tejido con la RTUP, ocurre algo de sangrado.  Un porcentaje pequeño de los pacientes tienen complicaciones debido a la pérdida de sangre durante o después del procedimiento.

Una ventaja de la RTUP es que el tejido prostático se manda a un laboratorio para hacer pruebas de cáncer.

Nuevos procedimientos para la HPB utilizan láser, microonda u otras fuentes de energía para vaporizar o destruir el tejido prostático.



Estos tienden a tener menos sangrado, pero como no se extirpa nada, no es posible realizar ninguna prueba.

Puede esperar estar hospitalizado de 1 a 3 noches después de una RTUP.     

La sonda de Foley generalmente se remueve antes de su alta.



Después de la cirugía de la próstata, algunos hombres sienten mejoría rápidamente, pero con frecuencia se puede tardar mucho más.  Habrá algo de sangre en su orina justo después de la cirugía y tendrá algo de dolor. Se puede tardar algunos días o semanas antes de que pueda orinar sin dolor o dificultad.

Puede ocurrir una retención urinaria e infección del tracto urinario, Llame a su médico si: no puede orinar, tiene fiebre, el dolor empeora o hay sangrado rojo brillante que no se detiene

La cicatrización en tejidos y nervios delicados puede ocasionar cambios permanentes después de la RTUP, incluyendo



Disfunción eréctil, 2 por ciento, o 2 de 100 hombres tendrán DE o dificultad con sus erecciones después de la RTUP

Incontinencia o fuga de orina para 10 por ciento o 10 de 100 hombres

y la mayoría de los hombres notarán menos semen o podrían tener una eyaculación seca.



Para evitar una cancelación o complicaciones por la anestesia o su procedimiento, su deber como paciente es no comer ni beber nada después de la medianoche, la noche antes de la cirugía, ni siquiera goma de mascar

Tome sólo los medicamentos que le dijeron en la mañana antes de la cirugía con un sorbo de agua

Pregunte cuándo descontinuar la aspirina o diluyentes de la sangre antes de la cirugía

Llegue a tiempo y tenga a una persona de apoyo disponible



Debe estar listo para verificar o confirmar su

lista de problemas médicos y cirugías

todos sus medicamentos, incluyendo vitaminas y suplementos

consumo actual de tabaco, alcohol y drogas

y todas sus alergias, especialmente a medicamentos, látex y cinta adhesiva



Avise a su enfermera, doctor y equipo de cuidados si tiene dificultad para respirar, mareo o dolor inesperado



Asegúrese de entender el motivo por el que se ha recomendado este procedimiento para usted.

Esto se considera una cirugía mayor, aunque usted pudiera irse a casa el mismo día.  Toda cirugía y anestesia tiene un pequeño riesgo de daños graves o muerte.

Si tiene preguntas sobre este procedimiento o necesita más información sobre las alternativas, pregúntele a su cirujano.



Este video sirve como herramienta para ayudarle a mejorar su entendimiento sobre este procedimiento.  No tiene como fin el reemplazar ninguna conversación o consejo de su médico.



PreOp® RTUP, Resección Transuretral de próstata Cirugía



Su médico ha recomendado que se trate su próstata con una RTUP, o Resección transuretral de próstata.



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#RTUP #TURP #Prostata #pacienteinformado

PreOp® Transrectal Ultrasound and Prostate Biopsy

Transrectal Ultrasound and Prostate Biopsy | PreOp® Patient Engagement and Patient Education



Prostate Biopsy how is it done? How to do transrectal ultrasound?

What is a transrectal ultrasound of the prostate?



Your doctor has recommended an exam of your prostate with a Transrectal Ultrasound and Prostate Biopsy.



Before we talk about this procedure let’s review some information about the prostate and why these tests may be necessary.

The prostate is located under the bladder and behind the penis.

It is a walnut-sized gland that is part of the male reproductive system. It helps make semen.



The Urethra is a tube that carries both urine and semen to the penis.  It passes through the prostate which surrounds it like a donut.



If you are scheduled for this procedure your surgeon is concerned that you may have prostate cancer. 



Prostate cancer is the most common cancer found in men.

At most risk are men age 50 and older and those with a family history, especially a father or brother with prostate cancer.

But at highest risk are african american men and men over age 70

 Usually there are no early signs of prostate cancer, but some men have problems with urination or pain that warn a physician that more testing is needed



Prostate Cancer Screening can help physicians find prostate cancer early, before a patient has problems. The screening includes

the digital rectal exam or DRE, where a physician examines the prostate for lumps by placing a gloved finger in a man’s rectum and

Prostate specific antigen or  PSA ,  is a blood test ordered for some men based on their age and risk factors.  Routine PSA testing is not recommended after age 70.



A prostate ultrasound with biopsies is done to test for cancer when a nodule or lump is felt. It is also done for a high PSA and for some problems especially with urination that can be a sign of prostate cancer.



With an ultrasound, your surgeon is able to scan and measure the prostate without xays or radiation.  The ultrasound also guides the needle used to biopsy your prostate.



The tissue biopsies are sent to a pathology lab for examination.

The next steps for your care are discussed after the procedure and with the final lab results.  This may take 1-2 weeks.



If cancer is found, the lab will give the tumor a number called a Gleason score, which is a grade of how abnormal or aggressive the tumor cells look.

 DNA gene testing is commonly done on the tumor cells as a new way to measure how aggressive the tumor is.

This is different than a cancer stage which is based on where, how large and if the tumor has spread. 



Treatment decisions for prostate cancer are based on many factors including a patient’s age and general health, the cancer gleason score, DNA results and  stage



A biopsy can be false negative 

That means  the biopsies did not find  prostate cancer that was there.



30 % of men with prostate cancer, about 1 in 3, will have normal biopsy results from the first procedure. .



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A second procedure with more biopsies is done to search for  prostate cancer if a PSA stays high, and cancer is strongly suspected but was not found with the first set of biopsies.

Sometimes MRI, Magnetic Resonance Imaging technology is used with the ultrasound to help find or target a tumor for biopsy.

Ultrasound guided prostate biopsy tends to be a short procedure,  available at many hospitals and is the most common procedure used to biopsy the prostate

MRI technology uses magnetic coils to get detailed information about the prostate and possible cancer. 

MRI is very expensive, takes longer to do, is newer and still being studied, is less available but is helpful in managing difficult cases



Now let’s talk a little more about what happens during a Transrectal Ultrasound and prostate biopsy.

To start, you are positioned comfortably. 

Most patients are awake for this procedure.



An ultrasound probe is coated with lubricant gel and gently placed into your rectum. The gel helps the probe to be more comfortable for you and is needed to get clear ultrasound pictures.



The size and shape of the prostate is checked and measured by gently moving the probe near the prostate.





Numbing medication is injected near the prostate to decrease the discomfort of  the biopsies.





The ultrasound probe is used to guide a needle biopsy device to take about 12  tiny pieces of prostate tissue.  You will hear a snapping sound with each biopsy.



After the biopsies the ultrasound probe and needle are removed.



This procedure is done as an outpatient, that means you will go home the same day as the procedure.



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#prostatecancer #MensHealthMonth #urology #healthcare #patienteducation

Cataract - Small Incision PreOp PreOp® Patient Education and Engagement

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Patient Education Company

Your doctor has recommended that you undergo lens replacement surgery to treat a cataract. But what does that actually mean?

The human eye is constructed like a camera - with a clear lens in the front. The lens is located just behind the iris. It is contained in an elastic capsule. This capsule will serve as the housing for the new lens. All light that enters the eye has to pass through this lens.

As we age, this lens can become cloudy and gradually lose its ability to focus properly. This is called a cataract.If left untreated, a cataract can grow steadily worse - interfering more and more with your vision.

Generally, replacing a cataract with an artificial lens is a simple procedure.

It usually involves a single incision in the white of the eye. Through this single opening the cataract is removed and the artificial lens is inserted.

Your Procedure:

On the day of your operation, you will be asked to put on a surgical gown.

You may receive a sedative by mouth and an intravenous line may be put in.

And you'll given eye drops to dilate, or open, the pupil.

You will then be transferred to the operating table.

To begin, the surgeon will use a special instrument to gently hold the eyelids apart.

Then the surgeon will apply an antiseptic solution to the skin around the eye before injecting a local anesthetic.

While the anesthetic is taking effect, the surgeon will position a microscope in front of the eye.

By now, the pupil will be fully open, or dilated.

When the operative field is numb, the surgeon will use the microscope to help make a very small incision just 3 millimeters above the iris. The lens is located just behind the iris contained in the elastic capsule.

Next the surgeon will open the top of the capsule and remove the lens. Most likely, your doctor will use a small probe which vibrates at a high frequency.

The probes vibrations break the old lens into microscopic pieces which can then be drawn out with gentle suction.

Through the small incision, the surgeon will then insert the new lens.

The lens is actually rolled up inside a special injector, designed to fit through the small incision made above the iris.

With the tip of the injector inside the eye, the surgeon slowly injects the new lens where it unfolds into position.

Because of the small size of the incision, often your surgeon will complete surgery without putting in any stitches.

Vision will gradually improve during normal healing over a period of 5 to 8 weeks.

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#cataractAwarenessMonth #optometrist #eyehealth #Cataract

PreOp® Rotator Cuff Repair Open Surgery

PreOp® Rotator Cuff Repair Open Surgery

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What is a Rotator Cuff Repair?



Rotator cuff is the term given to describe a group of four tendons that work together to support and stabilize the shoulder joint. Each tendon connects muscle to bone. When one or more of these tendons become damaged, the arm loses strength and mobility.



#rotatorcuffrepair #OrthoPCP #tenodesis #patienteducation

Myomectomy Vaginal

Vaginal Fibroid Removal Myomectomy Surgery • PreOp Patient Education & Patient Engagement

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Your gynecologist has recommended that you undergo surgery to remove vaginal fibroids. But what does that actually mean?

The uterus is part of a woman's reproductive system - it's the organ that contains and protects a growing fetus during pregnancy.

Fibroids are non-cancerous tumors that grow from the inner or outer wall of the uterus. They are quite common - as many as 20% of women over 30 will develop fibroids sometime during their lifetimes.

In most cases fibroids do not cause any discomfort and are never detected. Occasionally, however, fibroid tumors can cause problems. Complications from fibroid growth can include:

    * Pressure on the urinary system.

    * Pressure on the intestines.

    * Interference with the reproductive system

    * Or infection.

Because these tumors can grow to be very large, surgery is usually recommended in order to restore health and to protect the uterus.

Your procedure:

On the day of your operation, you will be asked to put on a surgical gown.

You may receive a sedative by mouth and an intravenous line may be put in.

You will then be transferred to the operating table.

To perform this procedure, your doctor will need unobstructed access to your uterus, so your feet will be raised, separated and placed in canvas slings - holding your legs in a position much like that position used during a routine gynecological exam. To begin, your genital area will be clipped or shaved and swabbed with an antiseptic solution and sterile towels are draped around until only the vulva is exposed.

Then the surgeon will use a gloved hand to conduct a vaginal examination and will check the size and location of the uterus by pressing on your lower abdomen.

Your doctor will then use a retractor to open the vagina.

Once the cervix is visible, a forceps is used to grasp the front lip of the cervix and to pull it forward - causing the uterus to open.

Through that opening, your doctor will insert an instrument called a hysteroscope.

A hysteroscope allows the surgical team to insert all necessary optical and surgical instruments into the uterus.

At the beginning of the procedure, a harmless gas or fluid will be introduced into the uterus, causing it to expand.

By inflating the uterus slightly, your doctor is better able to reach the operative site.

Next, a wire loop is inserted. This loop is used to grab the fibroid tissue and snip it free from the muscular wall of the uterus.

When your doctor is satisfied that all fibrous tissue has been removed, the hysteroscope and all other instruments are withdrawn. The gas or fluid is allowed to escape and the uterus returns to its normal shape.

#fibroids #Gynecology #WomensHealth 

Achilles Tendon Repair Surgery PreOp® Patient Education

Achilles Tendon Repair Surgery PreOp® Patient Education & Patient Engagement video Series



 Your doctor has recommended an open Achilles tendon repair surgery to treat your ruptured tendon.



This video should improve your understanding of the procedure.



The Achilles tendon is a strong band of fibrous tissue that connects the calf muscles in the back of the leg to the heel bone.



It is the strongest tendon in the body.



The Achilles tendon can tear slowly, a bit at a time, or all at once. 



When an Achilles ruptures, it means a tear has split the tendon apart.



This tear is often a sports related injury but it can happen to anyone.



A ruptured Achilles may be treated with or without surgery.



All treatment options require wearing a cast or boot for several weeks, followed by physical therapy for 4 – 6 months.



Surgery to repair a ruptured Achilles involves stitching the ends of the tendon back together.



A goal is to regain tendon strength.



Surgery can lessen the time a cast or boot is needed, and you may return to activity sooner than if it was not done.



The surgical incisions and techniques can vary depending on your surgeon and your injury.



Open Achilles repair surgery is done through one incision, large enough to see the split ends of the tendon to stitch them back together.



Open repairs have the lowest risk of re-rupture, the tendon coming apart after healing. They also have the highest risk of complications related to wound healing.



Some Achilles surgeries use very small incisions.



Patients have less pain and fewer problems with wound healing than with open surgery.



However, they have a higher risk of nerve injury because a nearby nerve cannot be seen when the tendon is stitched.



Achilles ruptures can heal without surgery, called non-surgical treatment.



The tendon heals naturally, supported by a cast or brace for up to 12 weeks, along with physical therapy for up to 6 months.



The healing process is slower than if surgery was done. 



There is no incision with non-surgical treatment, so it has the lowest risk of wound complications.



This is important for patients that are elderly, diabetic, smokers and/or those with poor circulation.



However, it has the highest risk of re-rupture compared to surgical treatments.



Patient Education & Patient Engagement





The Achilles to be repaired is marked while you are awake.



You will be given anesthesia to keep you free of pain during the procedure.



An incision is made along the damaged tendon.



The surgeon works carefully to reach the sheath, a protective layer around the tendon.



The sheath is opened to uncover the edges of the tendon.  Torn ragged fibers are trimmed to reach strong healthy tissue, cutting away as little as possible.



The surgeon weaves sutures through the tendon fibers in a pattern designed to hold with good strength.



The sutures are tied to position and hold the tendon ends together.



The sheath is repaired.



The surgical area is checked for bleeding, the skin is closed with suture, and a dressing is placed.



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Rotator Cuff Repair Arthroscopic

PreOp® Rotator Cuff Repair - Arthroscopic Surgery

Patient Education & Patient Engagement

What is Rotator Cuff Repair - Arthroscopic Surgery?

Rotator cuff is the term given to describe a group of four tendons that work together to support and stabilize the shoulder joint. Each tendon connects muscle to bone.

On the day of your operation, you will be asked to put on a surgical gown.

You may receive a sedative by mouth and an intravenous line may be put in.

You will then be transferred to the operating table.

If you are receiving general anesthesia, the anesthesiologist will administer it by injection and using an inhalation mask.

The surgeon will then apply an antiseptic solution to the skin and place a sterile drape around the operative site.

To perform arthroscopic surgery your doctor will make three small, button-hole sized incisions in the area around the shoulder.

An arthroscope is essentially a very small video camera that your doctor will use to guide the surgery. Before your doctor can insert the arthroscope, the surgical team will inject a clear fluid into the joint. This fluid will inflate the interior space around the surgical site and will help your doctor by providing an unobstructed view and enough room in which to work.

Your doctor will insert the arthroscope and inspect the surgical site.

If he or she decides that the team can proceed with the arthroscopic procedure, other small surgical instruments will be inserted through the other small openings.

First, your doctor will use a burr file to file away any rough edges on upper part of the shoulder bone called the acromion.

Under the deltoid muscle lies the bursa, a protective sac that prevents the rotator cuff tendons and the shoulder muscles from rubbing against each other.

Using a shaving instrument, you doctor will cut away the bursa to gain access to the damaged tendons.

Next, the surgeon will cut away any scar tissue or unhealthy tissue around the torn area.

Using sutures, the tear can now be repaired. One instrument places the sutures.

And then a second instrument fixes them in place.

When your doctor is satisfied that all possible repair has been completed, the instruments are removed and the clear fluid is allowed to drain from the shoulder.

Finally, a sterile bandage is applied. In order to keep the shoulder muscle immobile while it heals, you will be given a sling to wear.

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