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When a woman is diagnosed with vulvar cancer, surgery is the most common first step to remove all the cancerous tissue. Some normal tissue is also removed to help keep the cancer from coming back. Lymph node tissue from the groin may also be removed during surgery. Lymph nodes are small glands that make a colorless fluid and act as filters for the body. They keep bacteria and other matter from getting into the blood stream.
The type of surgery done depends on the location of the cancer and how involved it is. Your doctor will talk with you about what kind of surgery you need.
When you arrive for your surgery, please go to the Admitting Department in the main lobby of Brigham and Women's Hospital (75 Francis Street). You should arrive two hours before your scheduled surgery.
A receptionist will greet you and direct you to an admitting interviewer who will ask you for all necessary information for admission, verify your insurance, collect a deposit (if necessary), and have you sign a consent form for admission to the hospital.
You will be escorted to the Pre-Operative Surgical Area. Depending on the time of your surgery, you will either stay with the nurse or wait to be called for your surgery. Your family and friends will be directed to the Surgical Liaison Area, which provides information and a comfortable central location for family members to wait while surgery is underway.
You will be taken to an area where you will change into a hospital gown and be helped on to a stretcher. Next, you will meet the anesthesia team, who will place an intravenous needle in a vein. This will be used to administer medication to relieve anxiety and make you drowsy. You will then be moved into the operating room, which is staffed with physicians, nurses and technicians who involved with your care during surgery.
After surgery, you will be monitored closely. You will wake up in the recovery room where nurses will be checking your blood pressure and pulse frequently. Although you will feel like sleeping, occasionally you will be asked to cough and take deep breaths to keep your lungs clear. You will probably be receiving oxygen by facemask. If you feel cool, the nurse will give you extra blankets.
The nurses want to make you as comfortable as possible, so let them know how you are feeling. You will still have an intravenous (IV) tube in your arm or hand. If it feels uncomfortable, please tell your nurse. You may have a Foley catheter, which was put in during surgery to drain urine from your bladder. Surgical patients usually have plastic boots on their legs to assist blood circulation. If you wish to know about any equipment or procedures, the staff will be happy to explain it to you.
Once you have sufficiently recovered from surgery, you will be transferred to your hospital room. Once in your room, you may have visitors.
After surgery, you will probably feel weak and tired. You may find it difficult to do things for yourself. Your nurse will coordinate your care. This care will include pain control, personal care and discharge planning. Other members of the health care team will also help organize your care and will address your discharge needs.
The nurses will assess your ability to take fluids and foods. When you are taking enough fluids, your IV fluids will be stopped. On the night of surgery, your nurse will assist you with walking and personal care. On your first day after surgery, your urinary catheter will usually be removed. Your nurse will assist you in becoming independent with your personal care and walking.
After surgery, it is important that you take frequent deep breaths and cough every 15-20 minutes. Coughing, deep breathing and getting out of bed will speed your recovery. Deep breathing opens the tubes going to your lungs and helps to clear the lungs of sputum (spit).
It is normal to have pain or discomfort from your incision site immediately after surgery. Every patient experiences different levels of pain. Your comfort level will be monitored by your nurse. The nurse will ask you to rate your pain using a scale of one to 10. One is the lowest level of pain and 10 is the highest. Your nurse will make sure you are as comfortable as possible. It is important to communicate your needs. For the initial 12-24 hours after surgery, you may receive your pain medication by vein or injection. When you are ready (typically the first or second day after surgery) your pain medication will be in pill form. Again, you can use the one-to-10 pain scale to describe your level of pain, and the nurse can give you the amount of medication that you need.