Surgery

Asking your doctor what you should expect before, during and after your procedure will help immensely as you begin preparing for surgery. Discuss any medications you're currently taking and those you may have to take after surgery. Your doctor may ask you to quit taking some medications before your surgery. Don't hesitate to discuss any questions or concerns with your doctor and surgeon.

If your surgery will be at St. Luke's SurgiCare in the main hospital, you'll need to schedule a pre-surgical phone appointment. STAR (Surgical Screening Admission Registration) appointments are scheduled prior to your surgery. This phone visit will review your medical history and ensure that you're ready for surgery.

Call (319) 369-7827 to schedule your STAR phone appointment.

Call your insurance provider to confirm the details of your coverage and pre-certification. St. Luke's has a dedicated team of financial counselors. If you have questions about the cost of your procedure, please contact them at (319) 369-7513.

Plan on arriving at the hospital one and a half to two hours before your scheduled surgery time unless directed otherwise. You can park on Level 4 of the North Parking Structure.

You will receive specific instructions about how to prepare for your surgery. These may include information about your medications, instructions to stop smoking and guidelines for when you must stop eating and drinking. If you have not received these instructions, contact your surgeon's office or St. Luke's at (319) 369-7827.

Make sure you understand the instructions your doctor or nurse gave for taking medications prior to surgery. There may be some medications you should stop taking.

It is extremely important to follow instructions for eating and drinking because your surgery or procedure could be canceled or postponed if you don't observe the stated restrictions.

• Adults (age 13+): Nothing to eat or drink after midnight. This includes gum, candy and water. No smoking the day of your surgery.
• Children: No solid foods, candy or gum after midnight. Children may have clear liquids up to four hours before surgery unless otherwise directed. Clear liquids include clear carbonated beverages, water and apple juice (not cider).
• Infants: If your child is nursing, you can breastfeed or give breast milk until four hours before surgery. Infants who drink cow's milk, soy milk or formula must stop drinking six hours before surgery.

Note: It can be hard to explain to children why they can't eat or drink on the day of surgery. Be prepared with plenty of distractions for your child, such as books, toys and hugs. It's also helpful to keep food and drink out of sight.

On the day of surgery, bathe yourself or your child. Dress in loose comfortable clothes. Remove make-up and all nail polish and leave jewelry including wedding bands at home. Wear glasses rather than contacts (contacts must be removed) and bring a glasses case.

If you're arriving for an outpatient procedure, please keep bags to a minimum. You may want to bring a book or magazine. If you'll be staying in the hospital overnight, please bring your own sleepwear, slippers, crutches and slings, CPAP/BiPAP supplies, inhalers, toiletries and loose comfortable clothes (to wear home). For children, a special toy or blanket is suggested to help them feel more comfortable while in the hospital.

Remember: Bring your insurance and Medicare cards and your 'Preparing for Surgery' form with you.

Plan on arriving at the hospital one and a half to two hours before your scheduled surgery time unless directed otherwise. You can park on Level 4 of the North Parking Structure.

• Create eardrum opening
• Remove tonsils
• Remove adenoids
• Repair nasal septum
• Repair eardrum
• Probe eardrum structures
• Excise/repair mouth lesion
• Nasal/sinus endoscopy surgery
• Inspire implant for obstructive sleep apnea

There are several types of robots in use at St. Luke's. For urological, gynecological and some general surgeries, the da Vinci Xi Surgical Robot allows doctors to operate with greater precision and minimal discomfort for the patient.

The Robotic Surgery Process: Robotic vs. Conventional Laparoscopic Surgery

Robotic techniques can overcome many limitations posed by conventional laparoscopic surgery.

While the procedures vary, the process of robotic surgery typically involves the following:

• The surgeon sits at a special console throughout the robotic surgery.
• A very small 3D camera and dime-sized surgical instruments are placed inside the patient through tiny incisions near the abdomen. The camera gives the surgeon a magnified 360-degree view of the operative field and offers incredible clarity with high-definition 3D pictures, resulting in better visualization and precision.
• Using the console's hand and foot controls, the surgeon remotely moves robotic arms attached to surgical instruments. Fully articulating robotic arms mimic the motions of hands for better dexterity and control, whereas conventional laparoscopic instruments are scopes and long sticks that can't go around corners.
• A certified nurse assists directly at the operating table to confirm the correct placement of the surgical instruments.
• Many patients are back to doing what they love within a week after surgery.

Benefits of Robotic Surgery

Compared to traditional techniques, the very small incisions created by robotic surgery drastically reduce patients' time in the hospital and their risk of infections. The use of high-definition 3D cameras allows surgeons close-up views of areas they aren't able to see during open surgery. Fully articulating robotic arms mimic the movement of hands, allowing surgeons to have greater dexterity and control than is possible with conventional laparoscopic instruments.

Inside the OR

The diagram below illustrates the operating room layout for the da Vinci Surgical robot.

da Vinci Xi

Committed to bringing Eastern Iowan's the best surgical experience, St. Luke's invested in the newest robotic technology available. St. Luke's is the first hospital in Cedar Rapids to acquire the most advanced da Vinci surgical robot. The da Vinci Xi Surgical System was recently installed in St. Luke's operating rooms.

This is the fourth generation da Vinci robot, which has improved reach inside the body and provides surgeons an extended range of motion. These added benefits will aid surgeons performing several robot-assisted cancer surgeries at St. Luke's – with a primary focus on colon, prostate and general surgeries.

The Xi System immersive 3D-HD vision system provides surgeons a highly magnified view, virtually extending their eyes and hands inside the patient. The new surgical robot has an expandable technology platform designed to accommodate and seamlessly integrate a range of current technologies in areas such as imaging, advanced instruments and anatomical access. Since the robotic surgery program began in 2005 there have been over 8,000 robotic surgeries performed at St. Luke's.

The da Vinci surgical robot allows surgeons to operate through tiny openings – about the size of a dime. The surgeon uses a special console with hand and foot controls to move the robotic arms, which hold the instruments to operate. A small, 3D-HD camera helps surgeons see and perform intricate surgical procedures. The robot translates the surgeons' natural hand motions at the control console into corresponding movements of the robotic instruments.

da Vinci SP

St. Luke's is the first hospital in the state to perform surgeries using the Single Port SP Robot. The state-of-the-art technology of the SP robot paired with its innovative design – which enables surgeons to enter the body through one small abdominal incision before deploying the robot's surgical instruments – improves patient outcomes and recovery time. Currently, the SP Robot is the only FDA-approved robot for urologic surgeries.

• Shorter hospital stay
• Less pain
• Less risk of infection
• Less blood loss and transfusions
• Smaller incisions for minimal scarring
• Faster recovery
• Quicker return to normal activities
• Fewer complications
• Better clinical outcomes

Colorectal

• Colon cancer
• Rectal cancer
• Diverticulitis
• Inflammatory bowel disease (ulcerative colitis and Crohn's disease)

Gynecologic

• Hysterectomy for benign or malignant disease (common symptoms include fibroids, abnormal bleeding or endometriosis)
• Adhesions
• Myomectomy
• Tubal Reanastomosis
• Various Pelvic Relaxation Procedures

Urologic

• Prostatectomy