Charleston ENT
Associates
The South Carolina Sinus Institute
Surgery Center of
Charleston
The Surgery Center of Charleston is an independent surgical facility accredited by the Joint Commission on Accreditation of Healthcare Organizations. It is located contiguous with the Charleston ENT office on Savage Road. The purpose of the facility is to provide quality outpatient medical care and surgical services, while controlling costs and focusing on patient comfort and convenience. The facility was specifically designed for outpatient surgery and has been staffed and supplied with all equipment and personnel necessary to meet the needs of children and adults requiring surgery and general anesthesia.
Accreditation The Surgery Center of Charleston is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Local hospitals, Roper and Bon Secours St. Francis Xavier, are also accredited by the JCAHO.
Surgeons Each of the surgeons granted privileges at the Surgery Center are required to be board certified by their respective specialty board, or board eligible and in the process of board certification.
Anesthesia Services Anesthetics at the Surgery Center are provided by board certified anesthesiologists, who are physicians that subsequent to medical school have completed residency training in the specialty of Anesthesiology.
Staff Dawn Truslow, RN, MS, is the Administrator of the Surgery Center of Charleston. She oversees a highly-qualified and caring staff that provides the best of care to all Surgery Center of Charleston patients.
Is it safe to have surgery in a doctor's office?
What type of Surgery is performed at the Surgery Center?
How do I arrange to have my surgery at the Surgery Center?
Are there any specific instructions I must follow preoperatively?
Will I be able to drive myself home after surgery?
What can I expect postoperatively?
What if I develop problems postoperatively?
When will I meet my Anesthesiologist?
What does the Anesthesiologist do?
What types of Anesthesia are available?
Is Anesthesia safe?
Will I receive a separate bill from my Anesthesiologist?
Outpatient Surgery for Children:
What if my child needs outpatient surgery?
Is it unusual for children to have outpatient surgery?
Are there dangers in children having surgery?
How will my child be put to sleep?
How can I help prepare my child for surgery?
What will the anesthesiologist need to know about my child?
What if my child has problems postoperatively?
Is it safe to have surgery in a doctor's office?
Different television programs have recently brought to patients' attention the risks of surgery in a physician's office. While all surgery involves risks, most if not all of the programs mentioned pertain to office based surgery rather than outpatient surgery in a surgery center. These programs point to the importance of accreditation, and the need for quality trained personnel to provide care in these settings. They also address the need of such facilities to be prepared for and capable of dealing with unexpected emergencies. The Surgery Center of Charleston has been inspected and approved by the Joint Commission on Accreditation of Healthcare Organizations. Though the Surgery Center is contiguous with the Charleston ENT office location, it is a separate entity and was specifically designed and prepared to meet the needs of outpatient surgery. Competent board certified or eligible surgeons operate at the Surgery Center and anesthesia is delivered only by board certified physicians trained in the specialty of Anesthesiology.
What type of Surgery is performed at the Surgery Center?
Each case is addressed individually with attention to the specific needs of the patients involved regarding preoperative, intraoperative, and postoperative care. Almost any procedure that may be done as an outpatient may be considered to be done at the Surgery Center, however the specific needs of individual patients may necessitate some cases be done within the confines of a hospital.
How do I arrange to have my surgery at the Surgery Center?
Currently the Surgery Center of Charleston is utilized only by the surgeons of Charleston ENT Associates. When scheduling outpatient surgery, these surgeons consider any appropriate cases for scheduling at the Surgery Center. Subject to approval by the patient's insurer, the patient may be given the opportunity to have their surgery performed at the Surgery Center. Currently, most major insurers in the Charleston area participate with the Surgery Center and allow coverage of services provided within this facility.
Are there any specific instructions I must follow preoperatively?
Preoperative instructions will be discussed with each patient at the time of scheduling the surgery. Generally, most patients will need to refrain from eating or drinking for eight hours prior to surgery, with exceptions being made for small children and infants and patients with certain medical problems. It is especially important that solid foods be avoided. These precautions are necessary to decrease the risk of aspiration of stomach contents into the lungs during the surgery.
It is also important that each patient's medications be addressed on an individual basis. Generally, most patients will be asked to take any heart, or blood pressure medicine per usual routine. They will also usually be asked to avoid taking diuretics or "water pills" or diabetic medicines on the day of surgery. This should be discussed with your surgeon preoperatively.
Will I be able to drive myself home after surgery?
No. Patients who receive anesthetic agents may have altered coordination or decision making ability for many hours post operatively. It is important that each patient have a responsible adult they can depend on for assistance, including transportation, during the postoperative period.
What can I expect postoperatively?
The postoperative course is mainly dependent on the type of surgery performed. While all patients undergoing general anesthesia are at risk for experiencing some grogginess and or nausea postoperatively, other concerns such, as degree of pain or wound bleeding is more dependent on the type of procedure performed. It is important for patients to realize that most surgeries involve some degree of discomfort in the postoperative period. Though current pharmaceutical agents make such situations much more tolerable and less inconvenient than in the past, no medication is perfect. Since most narcotics and other analgesics may be associated with side effects, including nausea, the surgery center staff will attempt to find the most pleasing balance between analgesia and lack of side effects for each patient.
What if I develop problems postoperatively?
Once surgery is completed your physicians and recovery room nursing personnel will continually reassess your medical status. When you have recovered sufficiently to meet discharge criteria you will be allowed to go home. At the time of discharge, your postoperative instructions will be reviewed with you. These should be followed closely as they are designed to shorten your recovery period and give you the best chance for a good outcome. Once discharged, should you develop any problems that require attention, you may reach your physician, or one of his associates, twenty-four hours a day through the telephone numbers provided on your discharge instructions. In the unlikely event you might need immediate attention, you should proceed to the nearest emergency room and contact your physician from there.
All anesthetics at the Surgery Center of Charleston are provided by board certified physicians trained in the specialty of Anesthesiology. The Surgery Center currently does not utilize nurse anesthetists in the administration of Anesthesia and has no plans to do so.
When will I meet my Anesthesiologist?
Generally the Anesthesiologist will greet the patient on the morning of surgery and perform a thorough history and physical exam at that time, prior to the scheduled surgery. In the case of those patients with serious or unusual medical problems, the anesthesiologist may be introduced to the patient during the office visit when the surgery is scheduled, or the physician may call the patient or parent at home to discuss such problems. The Anesthesiologist will have reviewed the patient's history, when available, prior to or at such time and will also address any diagnostic testing that has been performed preoperatively. It is important that the patient discuss any significant personal medical history or problem with previous anesthetics with the anesthesiologist at this meeting.The patient should also discuss any family history of serious problems when exposed to anesthetics. This is also an appropriate time for the patient to express any concerns or ask questions regarding specific anesthetics.
What does the Anesthesiologist do?
Your Anesthesiologist will monitor and manage vital life functions such as blood pressure, heart rate, body temperature, and breathing, while administering anesthetic agents during the surgical procedure. Throughout surgery, the anesthesiologist is responsible for making medical judgments best suited to your intraoperative needs. He also will be responsible for monitoring your medical condition postoperatively in the recovery room, and managing those conditions that require treatment.
What types of Anesthesia are available?
Most otorhinolaryngologic procedures require general anesthesia in which the patient remains in an unconscious state, pain free, throughout the procedure. In some cases local anesthetics may be utilized with sedatives and analgesics as an adjunct. Generally the surgeon may discuss this with the patient at the time of scheduling, when local anesthesia is an appropriate option.
All anesthetic techniques are associated with some risks. Advances in pharmaceutical agents, monitoring equipment, and training of physicians over the past few decades has made the administration of anesthesia safer today than ever before for all age groups. It is important for patients to relate any current or previous medical problems to the anesthesiologist and to adhere to any preoperative and postoperative instructions to help prevent unwanted events.
Will I receive a separate bill from my Anesthesiologist?
Yes. Your anesthesiologist will bill you and your insurer in a fashion similar to your surgeon. Most, if not all, insurers will pay the anesthesiologist exactly as if the procedure had been performed in a hospital. You will be responsible for that portion of the bill remaining unpaid after your insurer has been billed. If your financial situation is a concern, it is best to discuss this with the anesthesiologist or his staff preoperatively. Every effort will be made to accommodate your specific needs.
What if my child needs outpatient surgery?
In most cases, if your child has no unusual medical problems, you and your child will meet your anesthesiologist on the day of surgery. Any questions regarding anesthesia may be addressed to the anesthesiologist at that time. It is important for you to understand that from the beginning to the end of the surgical procedure, you will have a physician specifically trained in anesthesiology monitoring, and attending to the needs of your child. It is also important for you to follow closely any preoperative instructions. For example, you must adhere to instructions regarding the intake of food and drink prior to surgery.
Is it unusual for children to have outpatient surgery?
Outpatient anesthetics for children, for certain operations such as tonsillectomy and myringotomy have become extremely common. A large percentage of the patients receiving care at the Surgery Center of Charleston are children. Our staff is comfortable dealing with the specific needs of children and do our best to make each experience as pleasant as possible. Many children may find the setting of the surgery center much more acceptable than that of a hospital.
Are there dangers in children having surgery?
Though any surgical and anesthetic procedure involves some risk, that risk is extremely small for healthy children. We screen all patients preoperatively and only those children who are deemed acceptable candidates, are scheduled for surgery at the Surgery Center of Charleston. Advances in pharmaceuticals, monitoring equipment and training of physicians has made surgery for children now safer than ever before. The Surgery Center of Charleston provides care to children of all ages on a regular basis and both staff and facility are capable of meeting the individual needs of any child.
How will my child be put to sleep?
There are different methods of starting the administration of anesthesia. Often, anesthetics are given via an intravenous line. This allows for the rapid onset of anesthesia and unconsciousness. This method, though most commonly used in adults, may also be used in children, especially those who are older and larger.
Another method utilized to begin anesthesia is to have you child breathe through a "space mask" until they fall asleep. Since this mask is attached to a circuit that includes a large bag to assist in breathing, the bag is often referred to as a "balloon" and your child is asked to "blow up the balloon." In these situations your child is reassured that no needle sticks will occur until after he is asleep. This technique is most often utilized in small children and may become more difficult to accomplish as children become larger than sixty or seventy pounds.
How can I help prepare my child for surgery?
It is important for you as a parent to prepare your child for his surgical experience. You can explain to your child the operation, why it is needed, and how it will improve your child's health. It is necessary to be honest regarding the situation, including relaying that there may be some discomfort afterward when that is expected. Reassure your child that though he will be in unfamiliar circumstances, he will meet many friendly doctors and nurses and you will remain close by. You might also discuss the "space mask" or blowing up the balloon discussed above, when that is the anticipated method of anesthesia administration. Though fear of the unknown is natural for both parents and children, it is best for you as a parent to maintain composure and refrain from showing anxiety. Anything you can do to relieve your child's anxiety will make the experience much more tolerable for both of you. Though natural to want to kiss your child prior to the surgery, it is best if the separation from parents is not associated with prolonged "good-byes" or tearful hugs from multiple family members, as this will only make the separation more difficult. Older and larger children (greater than sixty pounds) will probably need to experience one needle stick prior to surgery to begin an intravenous line and this should be explained to them preoperatively.
What will the anesthesiologist need to know about my child?
In order to provide the best care for your child your anesthesiologist will need to be familiar with your child's medical history. This includes you completing a medical history form in the physician's office on the day the surgery is scheduled as well as you relaying any significant medical problems to the anesthesiologist verbally on the day of surgery. It is especially important to make the anesthesiologist aware of asthma or any lung problem, any history of heart disease, diabetes, and any history of significant anemia (including sickle cell or sickle trait anemia). Any history of significant bleeding problems experienced by either your child or a family member should also be brought to the anesthesiologist's attention.
What if my child has problems postoperatively?
At the completion of surgery, your child will be continually reassessed and any needs addressed by the anesthesiologist. When the recovery room nurse and the surgeon and anesthesiologist feel your child has progressed to the point where he is medically stable and meets discharge criteria, he will be allowed to go home. At that point your discharge instructions will be discussed in detail and you will be given phone numbers you may use should you need to reach your physician at a later time. Events that should prompt you to call your physician include prolonged high fever, unusual drug reaction, nausea and vomiting resistant to treatment, inability to take oral fluids, or severe muscle cramps associated with discolored urine (red or dark). Excessive bleeding should also be a concern. You may call your physician at any time, twenty-four hours a day and he or one of his associates will respond to your needs. Should your child need immediate attention he should be taken to the nearest emergency room and your physician notified from there.