Surgery: What to Expect

The Children's Surgery Center, located on the second floor of UCSF Benioff Children's Hospital San Francisco, is a special suite of rooms designed especially to meet the surgical needs of children and their families.

It is different from UCSF Medical Center's adult surgical facilities in several ways. The instruments and equipment are designed for small bodies, and the center is set up to allow children and parents to be together as much as possible. We recognize the importance of the reassuring presence of parents when preparing for surgery and during recovery.

Our doctors, nurses and other caregivers have special training in dealing with children's illnesses. We have learned through training and experience how to communicate with youngsters who aren't able to express themselves.

Our Children's Surgery Center includes:

• Pediatric Surgical Waiting Area — This area, adjacent to the surgical suite, is where you can wait during your child's operation. You also are free to visit the cafeteria, gift shop and other facilities while you wait.
  
  When the surgery is finished, the surgeon will meet you here to tell you how it went and what you can expect. A short time later, a nurse will call the waiting area to ask you to come to the recovery room to be with your child.
• Induction Room — This is an area where you and your child can be together while the anesthesiologist starts the process of putting your child to sleep. For small babies, however — less than 7 or 8 months old — anesthesia is usually begun in the operating room.
  
  When it's close to the time for your child's operation, you and your child will be called to the induction area where nurses will check in your child. You will meet the anesthesiology team and nurses who will care for your child in the operating room. The anesthesiologist will ask questions about your child's health and previous experiences with anesthesia and answer any questions you might have.
  
  Most children are frightened of needles, so we give them anesthetic gas instead. Children often "go to sleep" in a parent's arms, and we have rocking chairs for that purpose. Once asleep, your child will be carried or transported on a rolling bed to the operating room where the anesthetic is continued. Parents then go to the waiting area.
• Operating Rooms — Your child most likely will be asleep throughout the surgery. Surgeons, nurses and anesthesiologists work together in the operating room to provide your child with comprehensive, coordinated care.
• Recovery Room — The recovery room is also called the post anesthesia care unit or PACU. When the operation is over, your child needs constant monitoring while his or her body stabilizes and the effects of the anesthesia begin to wear off. We know you will be eager to see your child and that your child will want to see you. We will call you to the recovery room as soon as possible, usually much sooner than you would be called for an adult's recovery.
  
  Recovery room stays can vary from 15 minutes to several hours, depending on the length of the surgery. Longer surgeries usually require a longer recovery period. When your child is ready, he or she will either be discharged and sent home with you, or taken to his or her hospital room. Children who need to go to an Intensive Care Unit will be taken there directly from the operating room.

Preparing for Surgery

You may schedule a pre-admission tour for your child by contacting Child Life Services at (415) 353-1203. Your child's doctor or staff also will instruct you about making an appointment at our pre-operative clinic, called the Prepare Clinic, to take care of tests and other preparations a few days before the operation. Sometimes, the Prepare appointment is scheduled for the morning of the operation.

If you and your child are coming to the hospital on the day of surgery, try to arrive several hours before the scheduled time of the operation. It takes time to process paperwork and, due to the possibility of last-minute cancellations because of illness, which are more common with children than adults, your child may be able to go the operating room earlier than expected.

Children who have already been admitted to the hospital will be transported from their hospital room to the Children's Surgery Center when it's time to prepare for surgery. If there is an intravenous line in place, the anesthesiology team may use intravenous medicine to let the child go to sleep, either before or after going to the operating room.

One of the more important requirements for anesthesia is that a child's stomach be empty. We ask that children not have anything to eat on the day of surgery. They may have something clear to drink, like water or clear apple juice, no less than two hours before the time of surgery. You will be contacted with the proper preoperative instructions before you come to the hospital.

Anesthesia

For many parents, the idea of their child receiving anesthesia is as frightening as surgery. The Division of Pediatric Anesthesia at UCSF Benioff Children's Hospital is comprised of highly trained, experienced anesthesiologists who understand the stressful nature of the surgical experience and the special needs of children and their parents. The majority of our staff is board-certified in both anesthesiology and pediatrics, and all have years of clinical experience with children. Several members of our staff also work in the Pediatric Intensive Care Unit or the UCSF Comprehensive Pain Service.

In addition to anesthesia during surgery, we provide pain control if needed after surgery, as well as anesthesia and sedation for many procedures outside the operating room, such as MRI, CT scan and radiation therapy.

We provide anesthetic services to patients as young as fetuses and premature infants. Our patients range from healthy children having minor procedures to critically ill patients or patients having complex operations.