Surgical Care | MaineHealth Maine Medical Center

Pre-Registration

Please pre-register as soon as your surgery has been scheduled. To pre-register, call 207-662-2433 or 800-619-9715 (toll-free), Monday - Friday, 7:30 am - 6:30 pm. Please have your health insurance information available.

Pre-Admission Screening

Once your surgery date is scheduled and you have pre-registered, the pre-admission screening office will mail you an appointment to meet with the anesthesia nurse practitioner and the pre-operative nurse. Your surgeon may decide that a phone call appointment will take care of this instead. In that case, a pre-admission nurse will call you about one week before your surgery.

At this time, a nurse will ask you about:

• Name, doses, and times of your medications (this includes aspirin, herbal medication, and inhalers)
• Allergies
• Health problems and past surgeries
• History of anesthesia complications or post-op nausea

Please let your surgeon know:

• If you are on blood thinners
• If you have a cold, fever, or change in your medical condition during the week before your surgery

Learn about our Pre-operative Readiness Education Program (PREP).

Before Surgery

All patients over 16 years of age:

• No food or milk after midnight (regardless of time of surgery).
• You may drink water, apple juice, black coffee, or black tea up to 4 hours before surgery.

All patients under 16 years of age:

• No food or milk after midnight (regardless of the time of surgery).
• Up until 2 hours before surgery: may have clear liquids (water, apple juice, white grape juice, cranberry juice).
• Up until 4 hours before surgery: may have breast milk.
• Up until 6 hours before surgery: may have formula or milk.

Day of Surgery

• Bring an accurate list of your medications with their doses as well as your medications in their original containers.
• If you have sleep apnea and use a CPAP please bring it with you.
• Bring two forms of ID (insurance card and photo ID).
• Make sure you have a ride home and someone to care for you at home.
• Leave all jewelry and valuables at home.
• Come showered, wear no jewelry or makeup.
• Remove body piercings.
• Bring a case for your glasses, contacts, and dentures.
• Wear comfortable, loose fitting clothing i.e., sweat pants for surgery and large button down shirt for shoulder surgeries.
• If you have been given any special equipment i.e., walker, crutches to be used after your surgery please bring with you.

Some people have anxiety and stress when they come to the hospital. MaineHealth Maine Medical Center offers a free class to help you understand these feelings. Relaxation skills can help patients recover more quickly. Our program teaches mind/body exercises. You will have the chance to develop a personal plan that meets your needs.

• Breathing exercises
• Music
• Imagery
• Positive thinking

This one hour class is taught by nurses trained to teach relaxation techniques for therapeutic benefits. The class is free to any patient scheduled for surgery or tests. Call 207-396-7280 to register.

The da Vinci surgical systems are designed to help surgeons perform minimally invasive surgery. Da Vinci systems offer surgeons high-definition 3D vision, a magnified view, and robotic and computer assistance. They use specialized instrumentation, including a miniaturized surgical camera and wristed instruments (i.e., scissors, scalpels and forceps) that are designed to help with precise dissection and reconstruction deep inside the body.

How is it use by surgeons?

• During robotic-assisted surgery the surgeon makes a few small incisions, and uses a 3DHD camera for a crystal-clear, magnified view.
• The surgeon sits at a console next to the patient and operates through the incisions using tiny instruments and the camera.
• The da Vinci robot translates every hand movement the surgeon makes in real-time, bending and rotating the instruments.
• The dual console potentially allows two surgeons to work together during one surgery for the most complex cases.

Post Anesthesia Care Unit (PACU)

After surgery, your loved one will recover in the post anesthesia care unit (PACU). 

• The PACU is a critical care area with many patients. To ensure the privacy of all patients, please stay focused on your family members during your visit.
• There are computers in the family waiting area where you can check on the progress of your loved one.
• Each patient is cared for by a registered nurse.
• Families are asked not to bring children under 15 years of age to the PACU.
• We are unable to provide supervision for children in the waiting room.
• Visitors are asked not to bring food into the unit.
• Cell phones cannot be used in the unit. We can tell you where you may use your phone.

Short Stay Unit (SSU)

The short stay unit is a unit where we care for patients who are 18 years and older, and that need to recover at the hospital for 1-2 days after their surgery or procedure. Our team is dedicated to helping you through the healing process. We promote your independence and encourage you to ask for our help and support whenever you need it.

After surgery, you will be taken to the Recovery area. Specially-trained registered nurses will care for you as you wake up from anesthesia. A care team member will make sure your family or support person is kept updated.

Your support person may join you at your bedside when you are feeling up to it. You will be discharged when you are safely ready. The nurse will give you written and verbal discharge instructions about your diet, activity, medications, and home care before you leave.

Kidney stones are painful, and many people will have them at some point in their lives. Prevention is the more effective, less painful and less expensive than treating and removing them. Our program can help prevent kidney stones in adults and children.

With the support of our team you’ll learn what changes you can make to prevent your kidney stones from returning. We offer advanced testing for the most accurate diagnosis, and we’re part of an active research program so we can continually learn more about how and why kidney stones form. Our research focuses on lifestyle, hormonal and genetic (inherited) risk factors. As a patient of the program, you may be asked if your information can be used in certain studies to help others in the future.

Evaluating and Diagnosing Your Kidney Stones

To prevent kidney stones we need to understand what is causing your stones to form. Using that information we can make recommendations about changes in diet or other areas and about medicines that will work for you.

How do we get that information?

• We’ll take a complete history of your or your child’s experience with kidney stones and your family’s history of kidney stones.
• Before your first appointment, you will need to collect your or your child’s urine over a 24- hour period.
• After your first visit, we will draw some blood.
• The urine and blood will be tested for unusual levels of chemicals or other things that may be causing stones.
• If a kidney stone has been collected, we will test it to see what kind it is.
• We may recommend that you or your child have imaging tests, like x-rays, MRI or CT scans, to learn more about any stones that are still in the kidneys.
• Sometimes, the tests we perform find diseases that are connected to kidney stones, such as osteoporosis (causes bones to become weak) and hyperparathyroidism (causes bone loss).
• These diseases can be treated, which helps prevent more kidney stones – and can improve your general health.

Creating Your Personal Plan

Once we have all the information, we will create a prevention plan for you or your child. The plan usually includes diet and other changes. It might include medicine.

Changes in diet

• Drink more water (or other healthy fluids) to keep stone crystals from forming and to flush away other things that can form stones.
• Stop adding salt to food and reduce the amount of salt (sodium) you eat in processed foods.
• Eat foods that contain calcium. (Be careful with calcium supplements, which can increase the risk of kidney stones.) We’ll advise you on the best way to keep a healthy amount of calcium in your diet.

Not every patient with kidney stones needs to see a dietitian, but some find that it can help in planning meals that lower the risk of kidney stones. If you or your child is overweight, our dietitian can help you plan meals to lose weight.

Medicines

Some people with certain kinds of stones can be helped with medicines that control minerals and acid in urine. The type of medication your doctor prescribes will depend on the type of kidney stones you or your child has.

Supporting You Long Term

Your plan’s success depends on your (or your child’s) commitment to it, because preventing kidney stones takes time. We will be with you every step of the way. We’ll keep track of how your treatment is working and make changes, if needed, to keep you healthy. These changes may include new prevention information we learn through our own research or from other specialists across the country.

Our goal, over time, is to prevent stones forming and to stop your kidney stone attacks. But, if you think you may be suffering from another kidney stone attack, you should contact your urologist first. Urologists are doctors who specialize in problems of the urinary tract, including kidney stones. Anyone with a history of severe kidney stones should have an urologist.

FAQs

What is a Litholink test?

Using a 24-hour urine sample, it measures urine factors that can prevent or promote kidney stone formation.

Why do I need a Litholink test before my appointment?

Treatments that help one person reduce their risk of kidney stones may not help another person. The Litholink test allows our doctors to create personal kidney stone prevention plans for each patient.

Why do I have to wait at least six weeks after a kidney stone removal procedure, a hospitalization, or a kidney stone attack to collect a 24-hour urine sample?

A 24-hour urine collection tells us about your body and what you eat when you’re feeling well.

Should I refrigerate my Litholink urine collection?

No, please don’t refrigerate your urine collection.

I forgot to collect my urine one time during my 24-hour collection. What should I do?

Please call the company that makes the Litholink test.

What should I do if I lost my Litholink order?

Please contact us and request another order slip.

Will my insurance cover this test and appointment?

While most insurance companies cover these costs, each company is different. It’s best to call the number on the back of your insurance card to be sure. You may need a referral from your primary care physician.

When is surgery needed?

Large kidney stones that are stuck in the urinary tract causing pain or bleeding or those causing an infection may need to be surgically removed. Our program’s goal is to eliminate the need to remove stones with surgery, and we often work with patients who had surgery for kidney stones and hope to avoid another one.