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Surgery


1. Pre-Surgery Prep:

Info & instructions: 
We provide Pre-Op, Post-Op and Pain education to all patients.

We also have instructions for specific procedures:
Total Joints, Hysterectomies, Back surgeries, Hernia, Total shoulders and T&A.  We also give out Smoking Cessation material in needed.

Why is it important?
It is important because we can spot problems that may cancel or delay surgery.   Labs, EKG’s, X-rays as ordered are completed and abnormal’s are reported to the surgeon.  We research cardiac and pulmonary studies for anesthesia.  If the patient is at risk for anesthesia we have an anesthesiologist review the chart recommend to go ahead with surgery, or get further studies prior to surgery.

How to make an appointment? 
Call the Pre-Surgery Clinic at 327-4035

How to reach us for questions? 
Call the Pre-Surgery Clinic at 327-4035

Who to call on the day of surgery? 
Call Out-Patient Surgery at 327-4215


2. Day of Surgery: 

What time to arrive: 
2 hours before scheduled surgery, unless 0730 case then 0600.

Pediatrics: 
1 hour before scheduled surgery.

What to bring with you: 
Wear comfortable clothes. LEAVE all jewelry and valuables at home.

How to reach us for questions: 
0545 to 2000 Out Patient Surgery Department 406-327-4215.

If you wake up sick: 
Call Out Patient Surgery department 0545 – 2000: 327- 4215.

Don't forget: 
Nothing to eat or drink after midnight!


3. After Surgery:

What to plan for:

  • Pain management: You will be given an RX to have filled at your pharmacy after surgery. Staff will go over pain control and non medication avenues. 
  • Visitors: We encourage you to bring 1 to 2 support staff. You will need to rest after your surgery.
  • Things to bring for personal comfort: music, favorite blanket, something comforting to you.
  • Pediatric patients: bring favorite toy or stuffed animal, blanket.

4. DaVinci:

There are 3 reasons why the da Vinci has been able to achieve such rapid growth and patient value over the last 5 years:

           1. 3 core features of the technology
           2. Access to the da Vinci Surgical System
           3. Proven clinical outcomes

  • There are 3 core features of the da Vinci Surgical System that enable surgeons to offer minimally invasive surgery in a safe, efficient, and reproducible approach while treating the most complex patients.  First is the 3D/High-Definition Visualization and 10X magnification – giving surgeons unsurpassed visualization for maximum accuracy and precision.  Second is the EndoWrist Instrumentation – providing surgeons with full range of motion (that mimics the human wrist) for superior surgical dexterity and precision.  And third is the Intuitive Motion. Surgeon’s movements are scaled and replicated precisely, while hand tremor is eliminated.
  • The end result?  You can also convert open surgery to a minimally invasive approach – extending the benefits of MIS to a broader patient base.
  • In 2010, the 8.5 mm endoscope for the da Vinci Si was launched.  And while this is presentation is a glimpse of future technologies, it is worth mentioning this endoscope.  Along with improved cosmesis and reduced port-closure time inherent with a smaller diameter endoscope is the ability to “port hop.” 
  • What I mean by “port hopping” is that the 8.5 mm endoscope can be delivered through da Vinci instrument ports, giving surgeons the ability to use this scope to take down abdominal adhesions prior to docking the system and without having to bring another vision tower into the OR.
  • Similarly, an existing feature on the da Vinci S and Si Systems is TilePro™.  This is a picture-in-picture technology designed to allow peripheral OR equipment to be connected into the da Vinci and displayed in the surgeon console.  In this video you see an example of interoperative laparoscopic ultrasound being displayed.  PAX images can also be inputted to review pre-operative imaging conveniently from the surgeon console.  This is the first step in image integration for da Vinci, providing additional visual inputs from the surgical cockpit.
  • And, for a glimpse towards the future of image integration, I would like to discuss fluorescence imaging for the da Vinci Si.  Imagine being able to see like Superman -- in this case not through brick walls but through tissue -- to ensure a better procedure and outcome for the patient.
  • Indocyanine green, most commonly referred to as ICG, is a cyanine dye used in medical diagnostics since 1957. Throughout the last 40 years, it has been used in cardiac, ophthalmologic and general surgery.
  • This dye is administered intravascularly and binds to blood proteins.  When an infrared light is shone upon the target anatomy, the ICG will glow, therefore allowing a surgeon to visualize vasculature and assess soft tissue blood perfusion. In a moment, I will show you some specific videos that highlight the utility of ICG. 
  • But first, let’s look at the Si hardware that has been optimized to enable fluorescence imaging.  First, a new illuminator was designed to output an infra-red laser designed to make the ICG to fluoresce in situ.  Second, updated cameras and endoscopes have new filters and coatings designed to allow the fluorescence signal to be passed.  And, third, new software algorithms interpret the infra-red fluorescence signal and “color” the tissue green to signify fluorescence (refer to lower right picture).
  • So now we truly have “night vision goggles” for da Vinci.  And toggling between normal white light mode and fluorescence imaging mode is as simple as tapping the camera clutch pedal.