What Happens in Surgery

Medically Reviewed by Jabeen Begum, MD on August 09, 2023
7 min read

As your surgery date gets closer, you might feel uneasy. But the more you know about what to expect, the less nervous you'll be. Take a few minutes to learn how the day will unfold.

You'll usually be asked to arrive about 2 hours before your surgery starts. A registered nurse will greet you and help you prep. You'll discuss your medical history and any medicines you take with your medical team. You'll also talk to your surgical team about the operation.

Before you go to the operating room, you'll change into a gown. The nurse will remind you to remove things like jewelry, glasses or contact lenses, hearing aids, or a wig if you have it.

A nurse checks your heart rate, temperature, blood pressure, and pulse. The surgeon may mark the spot on your body where the procedure will be done. A nurse places an IV line in your arm so the doctor can give you fluids and medicine during your procedure.

When it's time for your surgery, you're wheeled into the operating room on a stretcher.

A group of doctors and nurses work together to make sure everything goes smoothly. The specific people on your surgical team will depend on the type of procedure you're going to have. But in general, your team will have these pros:

Surgeon. This doctor leads the team and performs the operation.

Surgeons have to complete 4 years of medical school, plus at least 5 years of special training. They also have to pass a national surgical board exam. The surgeon you choose should be experienced in the type of procedure you're having.

Anesthesiologist. This doctor gives you medicine that makes you pain-free during surgery.

Certified registered nurse anesthetist. They assist your anesthesiologist and monitor you before, during, and after your operation to make sure you get the right amount of pain medicine.

Surgical tech. They set up the tools your surgeon will use and make sure the tools are sterile.

Operating room nurse. These nurses assist the surgeon during your procedure. For instance, they may pass instruments and supplies during the operation.

You'll get medicine, called anesthesia, so that you won't feel anything during surgery. The type of anesthesia you get depends on your health and the procedure you're having.

Local anesthesia. It blocks pain only to the part of your body where you have surgery. You'll still be awake and alert.

Regional anesthesia. You're injected with medicine that numbs a large area of your body where the surgery takes place.

IV-monitored sedation. This is used for minimally invasive procedures and less complex and short surgerieslike colonoscopies or biopsieswhere local anesthesia isn't sufficient and general anesthesia isn't required.

General anesthesia. It puts you to sleep during your operation. It's used for major surgeries. You get this type of medicine through an IV line or by breathing into a mask.

Once you're in the operating room, you breathe oxygen through a mask. Your anesthesiologist gives you medicine to prevent pain.

Your surgical team will track your health during the entire procedure. They'll probably use:

  • A clip on your finger to measure your oxygen levels
  • A cuff on your arm to monitor your blood pressure
  • Pads on your chest to keep tabs on your heart rate

Before the surgery starts, a nurse cleans your skin with an antiseptic to help prevent infections. They may remove hair from the area and place a sterile drape over your body. It will have an opening in the place where the surgeon will work.

It's rare to get an infection during surgery. Your team does everything it can to protect you. Your doctors and nurses will:

  • Clean their hands and arms up to their elbows with a germ-killing cleaner before the operation.
  • Wear masks, gowns, and gloves.
  • Clean the part of your body where the surgery is being done with a germ-killing soap.
  • Clean and cover your incision afterward.

They may also give you antibiotics before your procedure to help prevent an infection.

You'll wake up in a recovery room. A nurse checks your heart rate, breathing, and the bandaged incision. They might also ask you to take deep breaths and cough to clear your lungs.

You'll stay in the recovery room until you're fully awake and all your medical signs, like blood pressure and heart rate, are stable. How much time you spend there depends on what kind of surgery you had.

After that, depending on the type of operation you had, you'll be sent to a hospital room or will be able to go home.

Complications after surgery are always possible. But your surgical team will do everything they can to help you avoid them. Here are some potential risks you may face when you're in the hospital after surgery:

Medication errors

Getting the wrong medication, or the wrong amount of medication, is one of the most serious possible risks when you're in the hospital. The FDA gets more than 100,000 reports each year of suspected medication errors.

To reduce your risk of getting the wrong medications, make sure everyone on your medical teamyour doctor, surgeon, and everyone else involved in your careknows every medicine you take. That includes prescriptions, over-the-counter drugs, and supplements. After surgery, ask questions about any new medications you're given. Always make sure your nurse compares your ID bracelet to the name on the prescription.

Methicillin-resistant Staphylococcus aureus (MRSA) and other hospital-acquired infections

Another risk when you're in the hospital after surgery is infection. According to the CDC, 1 in 31 hospital patients have at least one hospital-acquired infection at any time.

One of the worst is MRSA, which is a type of staph infection resistant to many antibiotics. To prevent the spread of MRSA, ask your doctor if you'll be getting antibiotics before and after surgery. After your operation, be sure everybody coming in your room, including doctors, nurses, family, and friends, washes their hands before they touch you.

Pneumonia

Pneumonia is another common hospital-acquired infection, especially in those who spend time in the intensive care unit or are on ventilators. You can get an infection if germs enter through the ventilator tube and into your lungs.

You can also get pneumonia during your recovery because you're on your back and taking deep breaths is often painful. Some patients may also get atelectasis -- a partial collapse of the lung -- after anesthesia, prolonged bed rest, and shallow breathing.

You can reduce your risk of pneumonia with deep breathing. Try to take 10-15 big breaths every hour. And quit smoking at least 1 or 2 weeks before surgery if you're a smoker.

Aspiration pneumonia is a bit different. It's an infection of your lungs that's caused by breathing in fluids, like food, liquid, or vomit. It can also happen if you've had anesthesia because you can't cough. The best way to avoid aspiration pneumonia is to follow your doctor's orders about not eating or drinking before surgery.

Deep vein thrombosis (DVT)

DVT is when a blood clot develops, usually deep in the veins of one of your legs. If the clot breaks free and travels through your bloodstream, it can get lodged in the arteries of your lungs, cutting off the blood's supply of oxygen. This is called pulmonary embolism, and it can be fatal.

After surgery, your risk of DVT increases because you're often immobile in bed, making your blood more likely to pool and clot in your legs. The trauma of surgery itself also increases your blood's tendency to clot. Walking as much as possible, using leg compression devices, and taking blood thinners if your doctor prescribes them are all ways you can prevent DVT in the hospital after surgery.

Bleeding after surgery

Uncontrolled bleeding after surgery is not as much of a problem as it once was, thanks to advances in surgical techniques. But it can still happen.

Your doctor should know about all your medications, but if you take even an aspirin or ibuprofen within a few days of your procedure, alert your medical team. Common drugs can thin your blood. Also, tell your doctor if you've ever had excessive bleeding before, even for something like a dental procedure.

Anesthesia complications

You might worry about complications from anesthesia, but general anesthesia is very safe. Most people, even those with health issues, don't have problems. If you or a family member has ever had a bad reaction to anesthesia, make sure your doctor knows.

Older patients might be confused after surgery while the anesthesia wears off. And some people might have minor side effects like nausea, vomiting, dry mouth, and itching.

Speaking up lowers hospital risks

When you're in the hospital, it's easy to feel intimidated or even scared. But don't give up your control. You're your best advocate when it comes to your health care. Pay attention and ask questions if there's anything that concerns you or you don't understand.

Show Sources

SOURCES:

Agency for Healthcare Research and Quality: "Surgical site infection: prevention and treatment of surgical site infection."

CDC: "FAQs About Surgical Site Infections," "Questions and Answers about Healthcare-Associated Infections," "Overview of Pneumonia in Healthcare Settings."

Johns Hopkins Medicine: "Types of Anesthesia and Your Anesthesiologist," "The Surgical Team," "What to expect the day of surgery."

Kish Health System: "When You Arrive at the Hospital for Surgery."

Mount Sinai Hospital: "The Day of Your Surgery."

Sutter Health: "Abdominal Surgery: What to Expect While You are in the Hospital."

University of Chicago Medicine: "What to Expect When You Have Surgery."

Jama Network: "Preventing Venous Thromboembolism After Surgery."

Mayo Clinic: "General Anesthesia."

Peter B. Angood, MD, vice president, chief patient safety officer, The Joint Commission, Oakbridge Terrace, Illinois; co-director, International Center for Patient Safety.

Dale Bratzler, DO, MPH, medical director, Hospital Interventions Quality Improvement Organization Support Center (QIOSC), Oklahoma Foundation for Medical Quality, Oklahoma City.

Carolyn Clancy, MD, director, Agency for Healthcare Research and Quality (AHRQ), Department of Health and Human Services, Rockville, Md. Coalition to Prevent Deep Vein Thrombosis, press release: "Disease Backgrounder."

Nancy Foster, vice president, quality and safety policy, American Hospital Association, Chicago.

Fran Griffin, RRT, MPA, director, Institute for Healthcare Improvement, Cambridge, Massachusetts.

Institute of Medicine: "Report Brief, July, 2006: Preventing Medication Errors."

Joint Commission: "Things You Can Do to Prevent Medication Mistakes."

Medicare Quality Improvement Community: "SCIP Target Areas."

FDA: "Working to Reduce Medication Errors."

American Society of Anesthesiologists: "Types of Anesthesia."

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