Keyhole Shoulder Surgery
If you have decided to undergo a keyhole operation (arthroscopic) your surgery would usually be performed in the Ulster Independent Clinic except by special arrangement.
Admission to hospital is usually on the day of surgery and occasionally on the evening prior to surgery. All arrangements in relation to this will be made through the Ulster Independent Clinic. They will inform you 7 – 10 days prior to your admission date about the details of your admission. The arthroscopy of your shoulder will involve a general anaesthetic which will last anywhere between 30 minutes and 1 ½ hours depending on the procedure required. At the time of administration of your general anaesthetic you will also undergo a shoulder nerve blockade using a long lasting local anaesthetic. However local anaesthetic and sometimes steroid will also be administered to your shoulder at the end of the surgery.
If you undergo a rotator cuff repair you will have to wear a sling for 6 weeks following surgery on a day and night basis. You will require considerable input from others to enable you to wash and dress. You will not usually be able to drive a car from 6-8 weeks following surgery. If you undergo a shoulder stabilisation you will also have to wear a sling for this time period. You might well require some input in terms of help to wash and dress following a shoulder stabilisation. If you undergo a decompression of your shoulder you may require a sling for the first few days only. You might again require a reasonable amount of input in terms of help to wash and dress following a decompression of your shoulder.
You will be seen on the evening of your surgery and again on the morning after surgery. Your discharge will usually occur somewhere between 10 and 11 o’clock in the morning after you have been assessed by the physiotherapists. In the majority of instances the small keyhole wounds around your shoulder will be closed with paper strips and therefore do not have to be removed. I usually ask that you leave the dressings undisturbed after surgery and fresh dressings will be provided for you to put on top of the dressings administered in theatre. If at all possible you should keep your shoulder dressings dry following surgery. You can use the hand piece of your shower to spray your body but please keep the water away from your shoulder.
You will be provided with appropriate analgesia to take home after surgery which should last you for 3 or 4 days. More pain relief can be obtained through your General Practitioner’s surgery and we will provide you with a letter to request this from your General Practitioner.
At the time of your surgery an information sheet in relation to pain relief will be placed into your note. This will also contain your review appointment following surgery which will usually occur within 10-14 days of your operation. At that stage your wounds will be checked and further physiotherapy, if appropriate, will be organised for you at that stage.
If you have any further questions in relation to your surgery, please do not hesitate to contact my office.
Anaesthesia
Dr Foster, Consultant Anaesthetist, will meet with you on arrival at the Ulster Independent clinic. He will ask questions about your general medical health and medications that you take. He will answer any questions about the anaesthetic at this time and given information about any risks or side effects of the anaesthetic. The anaesthetic for shoulder surgery is a General Anaesthetic. When you arrive in theatre a plastic cannula will be placed into a vein in your hand or arm. You will then be given some oxygen to breathe as the heart rate and blood pressure monitors are being put on. The anaesthetic will start with an injection through the plastic cannula and a breathing tube will be inserted once you are anaesthetised. Once the surgery is finished you will be woken from the anaesthetic and the breathing tube will be removed. You will then be moved to the recovery ward for monitoring before being transferred back to your room once you have recovered from the effects of the anaesthetic. It is common to have a slightly sore throat after the anaesthetic, this is usually mild and resolves after 1 or 2 days. You will have been given pain killers and anti sickness drugs when you are anaesthetised. If you are sore or feel nauseous in the recovery ward this can be treated with more medication. It is common to have a mild degree of pain after surgery and this will be treated with painkillers in hospital and you will be given painkillers to take once you are discharged from hospital along with a letter for your GP allowing you to get more as needed. Dr Foster will visit you on the morning following surgery to check that your pain is controlled and arrange suitable painkillers for discharge.
About Dr Foster
Dr Foster studied Medicine at the University of Dundee. He qualified as a doctor in 1994. After gaining experience in medicine and surgery he began training in anaesthesia. He became a fellow of the Royal College of Anaesthetists (FRCA) and a fellow of the Faculty of Anaesthetists at Royal College of Surgeons in Ireland (FFA RSCI) in 1999. He finished his training in Anaesthesia in 2004. He spent a year working as a clinical fellow at the University of Western Ontario and St Joseph’s Hospital, Canada where he gained experience in peripheral nerve blocks using ultrasound. In 2005 he returned to Belfast to take up the post of consultant anaesthetist and Belfast City Hospital and Musgrave Park Hospital. His areas of special interest include: peripheral nerve blocks, anaesthesia for orthopaedic surgery and advanced airway management.