Frequently asked questions

General

You will have the opportunity to talk about the date of the operation during an out-patient examination or we will inform you in time by calling you.
There is a possibility that additional examinations will be necessary. Before surgery, you must stop taking certain medication which influences blood clotting or start taking injections as prescribed by your physician. You are expected to be fasted before you are admitted to hospital. It is recommended you take a laxative the day before surgery. A few days before going to hospital, you should shower twice per day using soap and water, paying special attention to the chest area. This is necessary, since it reduces the number of microbes on your skin. You should not shave the area that will be operated on at home, since bad shaving can cause inflammation and infection of the wound. You are also asked to take a shower in the morning, before being admitted to hospital.

The operation is performed on the day you are admitted to the hospital. After the operation, you will wake up in the intensive care ward, where you will be constantly monitored and checked. You cannot be released from the hospital until the chest tube is removed from your chest. Patients are usually released from the hospital in 4 or 5 days after the surgery; however, this mainly depends on how you are feeling. 

The operative wound is usually located on the lateral side of the chest, between the ribs. It is our wish that you feel as comfortable as possible, which is why we continuously supply pain medication into your vein; later, we continue to supply it in the form of injections or pills. You may still experience some pain in this area several weeks or months after the operation. What is important is that you do not feel the pain and you are capable of performing breathing exercises, coughing and moving without problems, which is paramount after the operation. We kindly ask that you inform us the moment the pain starts to surface, since it is easier to control at this stage than later on, when the pain becomes stronger.

Usually, there is no need to remove stitches after the surgery. The wound is closed from the internal side and the stitches are reabsorbed by themselves or simply melt. The only stitch that needs to be removed is located in the area of the thoracic tube. The wound will be dressed before you are discharged from the hospital. Normally, changing your bandages is not necessary at home, except in the event of fluids escaping from the wound or if the plaster becomes wet or dirty. The plaster can remain on the wound for a few days, then you may remove it. When you return home, you are allowed to shower with water and soap and gently dry the wound. It is not recommended you take baths for at least a month following the surgery. 

It is perfectly normal that you feel tired and worried in the first couple of days after coming home from the hospital, which is why you need lots of rest. We recommend that you gradually increase your everyday activities and perform the breathing exercises which you learn at the hospital. You should avoid lifting heavy weights for at least six to eight weeks. Go out for a daily walk.
Whenever pain arises, you must take the medication prescribed by the physician. You can also help yourself by warming that particular part of the wound, which usually reduces the swelling and pain. When coughing, place your hands against your chest or support the area with a pillow. After surgery, it is usually not necessary to take other medication (besides the usual therapy). Make sure to eat healthy and varied food and drink enough liquids.

You should call a doctor whenever the following problems arise:

  • You have problems breathing.
  • The wound becomes swollen, red or pus or liquid starts coming out of it.
  • You start running a fever.
  • You start experiencing significant pain.

The following complications may arise during lung surgery:

  • Bleeding 
  • Inflammation of the wound or chest cavity
  • Long-term escape of air from the lungs
  • Damage to the heart, lungs and major veins or nerves during surgery
  • Long-lasting pain
  • Pneumonia
  • Complications due to the general anaesthesia

The tissue, extracted during surgery, is sent off for tests. The report is expected back in seven to ten days. The doctor will inform you about the results over the phone or during a control visit at the out-patient clinic.

This answer can only be answered after we receive the medical report. Depending on the type and size or spread of the tumour, the medical council will decide on further treatment steps.

Thyroid Surgery

The operation is performed on the day you are admitted to the hospital. You are free to leave the hospital the next day.

  • When completely removing the thyroid gland, it is necessary to take a small pill which provides a supplementary thyroid hormone every morning on an empty stomach. You must take the pills your entire life; however, they have no side effects. They enable you to have a perfectly normal and active life. You need to undergo regular control examinations with a physician and monitor the quantity of the hormone in your bloodstream.
  • When undergoing the partial removal of the thyroid gland, you may not need to permanently take pills. Following check-ups, the quantity is modified or completely cancelled, in the event the remaining part of the thyroid can produce enough of the hormone.
  • A reduction in your calcium levels (hypocalcaemia) is a transitional or permanent state which most often arises following the complete removal of the thyroid gland. The reason for this is in the direct damage done to the parathyroid glands, the reduction in the amount of blood they receive or the removal of these glands. Transitory hypocalcaemia is common; this, however, does not mean that the parathyroid glands are permanently damaged. This state requires that the calcium is supplemented in the form of pills until the parathyroid glands start to re-activate. Usually, this can take anywhere from a few days and up to a month or two.

The thyroid gland is located close to the vocal cords and nerves which connect to the vocal cords. Following surgery, your voice can change to a small degree, usually becoming weaker and hoarse. These changes usually reverse themselves in 2 to 3 months; in only rare cases do they become permanent.

An unpleasant feeling of tightness and tightening is present in the neck area. The most unpleasant feeling is usually present when swallowing due to the pain in your throat. You will be given pain medication, first intravenously and then in pill form. The unpleasant feelings dissipate the very next day, when you are able to normally get up and walk.

A scar is always present following thyroid surgery and is located in the skin fold on the lower part of the neck. During the first few weeks, it is slightly painful and a swelling usually develops above it. Both disappear on their own and no action is necessary. During then period, when the wound is healing, we advise against sunscreen and exposure to UV rays in tanning salons.
Some people experience more prolonged wound healing. The wounds are darker and thicker than normal. Since it is impossible to foresee this problem, make sure you inform the surgeon that you have noticed similar problems in the past.

The wound is usually closed with internal stitches which do not need to be removed. You can remove the plaster from the wound in a couple of days. You can wet and gently wash the scar; however, taking baths and swimming is not advised for at least a month. When the scar is ready in a month or two, you may apply salves to it that soften the scar, make it more flexible and less noticeable.
The skin around the scar area is usually insensitive to the touch, which is normal. The feeling returns in a couple of days.

Please call your physician should any of the following symptoms arise:

  • Signs of reduced levels of calcium in the bloodstream – tingling in your fingertips and in the area around your mouth or cramps in your limbs.
  • A running fever.
  • The spread of red or swelling around the operative wound.
  • Oozing from the operative wound.

The parathyroid glands, which control the level of calcium in the bloodstream, are located next to the thyroid gland. They can be damaged during surgery which interrupts their functioning for a limited period of time, resulting in below-normal calcium levels in the bloodstream. You can feel this as tingling (feeling pins and needles) in your arms, fingertips, legs and in the corners of your mouth. This is then followed by painful cramps, which also include the throat, resulting in laboured breathing. Please let us know about these early symptoms during your stay at the hospital and talk to your physician if the signs or symptoms appear at home. This complication is more probable when the entire thyroid gland is removed, which is why we will take a blood sample and test it for calcium levels when you are still at the hospital. If necessary, you will be given a calcium supplement and intravenous medication. From time to time, you may also need to take vitamin D. In just a couple of days, the parathyroid glands regain their abilities and your body normalises.
It is recommended that you consume additional quantities of milk and dairy products following the operation, since they are rich in calcium.

The doctor will explain how the surgery went immediately after you wake up from the general anaesthesia. The removed thyroid gland is sent for laboratory tests and the results are available in 7 to 10 days. We will inform you about the results during your first visit or by telephone.

We recommend a week or two of bed rest at home. During this time, you will be able to perform less demanding physical activity and workloads. You will generally be able to return to work in 2 to 3 weeks, depending on the type of work and your general feeling.

You should avoid lifting heavier loads and do exercises targeting the shoulder and neck areas.

Laparoscopic procedures

This surgery is necessary when GERD treatment with medication is unsuccessful and the lower oesophageal sphincter is not functioning properly.

Laparoscopic surgery is possible under the following conditions:

  1. You have never had surgery in your abdominal cavity.
  2. You are not pregnant.
  3. You have no prior medical issues, such as heart failure or lung disease.
  4. You have the majority of GERD-related symptoms:
  • You experience a burning sensation behind your sternum when consuming food and which lasts from several minutes to several hours.
  • You experience pain behind your sternum, especially when you bend over, lie down or eat.
  • The taste of burning, sour, salty liquid in your throat.
  • Difficulty swallowing.
  • The feeling of food getting stuck in your chest or throat.
  • Chronic irritating caught, a sore throat and a hoarse voice.

Whenever these criteria are not met, a more invasive, traditional surgery is required, called a laparotomy – entry into the abdominal cavity through a larger surgical incision in the stomach.

Complications during surgery are rare, however there is also a possibility that they may occur.

  • The local organs and tissues may be damaged during surgery – the liver, the oesophagus, the spleen and the stomach.
  • Problems with swallowing after surgery can be the result of the stomach being to tight around the oesophagus.
  • The artificial sphincter can give way.
  • The usual complications accompanying every major surgery and general anaesthesia.
  • An increased feeling of bloating in the stomach and the disadvantages due to the reduced capacity for belching.

Some of the problems, which occur after surgery, cannot always be treated. In a small number of cases, GERD symptoms may re-appear even after surgery. In some cases, new symptoms emerge, such as bloating, wind, difficult belching, vomiting or problems with swallowing due to the stomach being to tightly pressed against the oesophagus.

Yes, the surgeon closes the entry wounds on the stomach. The wounds should be covered, then you can remove the plasters. You can take regular showers; the water and soap can also touch the wound. Make sure to gently dry the wound. The stitches are removed either by the surgeon or your personal physician 7 to 10 days after the surgery, or else the stitches dissolve by themselves.

Post-operative pain can be present especially in the area around the stomach and shoulders. The nasal tube also causes discomfort. You will be given pain medication, first intravenously and then in capsule form. We kindly ask you to tell us if you feel pain and we will solve the problem together.

You will be asked to do an out-patient examination with a surgeon. The surgeon will check all the necessary medical reports and will explain the operating procedure, the possibility for complications and side-effects, as well as answer all your questions. You will be given instructions on possible further examinations and discuss the date of the surgery.

Make sure to eat lightly the day before the surgery; we recommend you take a laxative. Make sure you have a good shower and remove all jewellery and make-up before being admitted in the morning. It is not necessary to shave the operative area; this will be done by staff at the hospital.

You need to have an empty stomach before being admitted to the hospital. Make sure you follow instructions about taking your regular medication and the admittance to the hospital. You can find them in the Patient Instructions section.

The operation is performed on the day you are admitted to the hospital. A tube is inserted into your stomach through the nose in order to prevent vomiting. The next morning, the tube is removed and the oesophagus and the stomach are X-rayed. If the results are normal, you can already leave the hospital after breakfast or the morning lunch.

Scars following laparoscopic surgery are minimal. They are noticeable until the wounds heal completely and they later fade with time.

Upon being discharged from the hospital, you will receive a discharge letter and the doctor's telephone number. Call your doctor if one of the following problems should arise:

  • Increased discharge from the wound in the abdomen.
  • Pain and swelling in the part of the abdomen.
  • Persistent irritating cough.
  • Difficulty breathing.
  • Increased body temperature.
  • Trouble swallowing.
  • Continuous nausea and vomiting.

Certain types of food can aggravate the disease in three ways: 

  • Caffeine and alcohol stimulate the release of acid. If the stomach contains a higher quantity of acid, there is also a greater possibility for reflux into the oesophagus.
  • Fatty foods slow down the contraction of the stomach – the peristalsis, food is stalled in the stomach and the contents flow into the oesophagus.
  • Caffeine, chocolate and peppermint reduce the pressure in the oesophageal sphincter, which enables acid to flow into the oesophagus.

We recommend a week or two of bed rest at home. During this time, you will be able to perform less demanding physical activity and workloads. You will be generally unable to return to work for 2 to 3 weeks, depending on the type of work you do and your general well-being.

You should avoid lifting heavy loads; when you experience heavy coughing, you should press your hands onto your stomach and do stretching exercises.