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Frequently Asked Questions (FAQ)



The day of surgery > > >

How long will it take?
For day surgery the whole process takes about ½-2/3 of the day. You will come to the front reception desk of the hospital then go to preadmission where the nurses will check you in and get you changed for surgery.

After the operation there is some time spent in recovery where you wake up from the anaesthetic. I will come and talk to you and your family about the surgery and check that you are comfortable.

After that, you will be discharged after you have had some food and drink and visited the bathroom.

What do I bring?
It is very important to bring all of your imaging, including X-rays, CTs, MRIs and ultrasounds.

Post surgery > > >

When can I drive?
It isn’t legal to drive for 24 hours after a general anaesthetic and it isn’t safe either – plan to have someone take you home.

I am happy for you to drive when you feel safe and comfortable, which might be as soon as two or three days after minor surgery such as carpal tunnel release, trigger finger release or De Quervain’s release.

What can I do with my hand post surgery?
You should keep the hand up as high as possible, positioned on some pillows or in a sling for the first 2-3 days. This will minimise pain and swelling, allow you to take less pain relief and to get the hand moving more quickly. After 2-3 days, if the hand doesn’t throb it can be lowered.

After the first 2-3 days of elevation I am happy for you to use the hand to type, write, eat and drive. You should use common sense and avoid doing to much with the hand as it may cause it to swell.

It is important to avoid getting the hand wet to minimise the risk of infection.

What do I do about the dressings?
Please leave them intact until I see you again. If they accidentally become dirty or wet please call the rooms on 02 9437 1211 for advice; generally they will have to be redone.

When can I return to work?
This depends on the operation you are having and the type of work you do – broadly manual vs. clerical/white collar.

After carpal tunnel surgery most white collar workers can RTW within 1-2 weeks whilst manual workers will need more like 6-8 weeks. Trigger finger and de Quervain’s surgery are similar.

When can I return to sport?
After operations like carpal tunnel releases, trigger finger releases and so on I am happy for you to start running or walking as soon as the hand does not throb when it is lowered, usually after 2-3 days. Swimming isn’t possible until the dressings have been removed and the wounds have healed.

What is the role of hand therapy?
The hand is a complex and delicate organ and to ensure an optimal result after surgery hand therapy is sometimes necessary, particularly after operations like Dupuytren’s releases and after complex trauma. I am fortunate to work with excellent hand therapists at St Leonards, the Children’s Hospital and in Dubbo. Patients have the option of being treated in the public system by some outstanding therapists without cost, or of enjoying the convenience of seeing the private therapists located immediately next door to my North Shore Private Rooms.

Children > > >

Can my child have a local anaesthetic?
No, it is very distressing for a child to have a surgical procedure under local anaesthetic. It is much better for them to have a quick general anaesthetic. When the surgery is finished I put a lot of local anaesthetic around the wound and this is usually very effective in controlling pain.

When is it safe for a child to have an anaesthetic?
It is safe for a child to have a general anaesthetic after the age of 3 months if absolutely necessary but if possible I prefer to operate at 12 months or older when the baby and his/her hand is bigger; this also makes things easier for the anaesthetist. As a rough guide syndactyly release is performed around 12 months, excision of extra toes around 18-24 months and trigger thumb releases at any time after 24 months.

Why is the bandage so bulky?
As you know kids are magicians when it comes to wriggling out of things. It is embarrassing for the surgeon and painful for the parents and child to have the dressings fall off in the recovery room so our dressings and bandages are designed to stay on!

Health system > > >

What is involved in becoming a surgeon in Australia?
Surgeons are graduates of a medical school. When I went through medical school this took six years; many medical schools now offer postgraduate medical programmes where some one with an undergraduate degree in science, engineering, the arts etc does a four year degree in medicine.

Following this there is an internship lasting one year where the doctor does terms in emergency medicine, surgery and medicine. By the end of this year most people know roughly what direction they want to head and stream towards surgery, medicine, obstetrics, family medicine and so on. People headed towards surgery then spend one to years as a resident medical officer doing mainly surgery, and by that stage will know what surgical speciality they wish to pursue.

Trainee surgeons are called registrars in Australia and UK and residents in the US. In Australia doctors are registrars for around 6 years, and they are then allowed to sit their final specialist examinations in, for example, orthopaedic surgery.

At this point, surgeons can put out their shingle but most in Australia pursue sub-specialisation in an area such as foot and ankle, shoulder, or in my case, hand surgery. This is done by doing a fellowship for a year or more in that area of interest. I spent a year at Duke University in North Carolina, which is famous for its microsurgery (the senior surgeon there, Professor Urbaniak has replanted more than 1200 parts and has written many textbooks on microsurgery). In this year one concentrates solely on that area and usually does some research as well.

After fellowship surgeons are ready to begin their careers in their chosen field.

What is the difference between surgery in the public and private systems?
Private patients essentially have a contract with their treating surgeon. The surgeon is directly responsible for the operation, does it him or herself, and carries out the aftercare. Typically the patient has easy access to the surgeon and plenty of time to discuss the operation and its implications, and is also able to get in contact with the treating surgeon if there is any problem postoperatively. Another big benefit of the private system is the ability to choose the date of the operation to fit in with your other commitments.

In the public system the patient is looked after predominantly by the hospital system and the flexibility provided by the private system is lacking. Treatment is by the team as a whole, including the consultant surgeon and trainee surgeons. We pride ourselves on the excellent treatment provided by our team at Royal North Shore Hospital and the New Children’s Hospital, but access to elective surgery is constrained by the system and some time on the waiting list is usually necessary.

Clinics


ST LEONARDS
Suite 1, Level 4
North Shore Private Hospital
Westbourne St
St Leonards NSW 2065

DUBBO
Dubbo Private Hospital
Moran Drive
Dubbo NSW 2830

Ph: 02 9437 1211