Welcome to your child's Surgical Experience at the C.S. Mott Children's Hospital, part of the University of Michigan Medical Center. We care for children of all ages, undergoing surgical procedures on an outpatient and inpatient basis.

We have 8 full-service operating rooms and 2 minor-procedure rooms. The American College of Surgeons qualifies us as one of 13 Level I Pediatric Trauma Centers in the country. We provide comprehensive pediatric preoperative care, be it outpatient, admission post-procedure, planned in-patient, or trauma.

Before Surgery

In general, children may have their regular diet/ formula until midnight the night before surgery (exception for infant's 0 - 3 month's age). After midnight and until 3 hours before surgery time, Water, Pedialyte, and Apple Juice Only are allowed. Then for 3 hours prior to surgery, nothing at all is permitted. Children must have an empty stomach to receive anesthesia. Due to the risk of serious lung problems from vomiting or regurgitation, surgery will be cancelled or delayed if your child eats or drinks past the specified time.

The following symptoms or illnesses (current or within the past 6 weeks) should be reported to the Mott Outpatient Surgery Nurse at the time of the preoperative phone call: Croup, bronchitis, bronchiolitis, or pneumonia (all may cancel surgery for 4 - 6 weeks).

Due to the effect on bleeding, aspirin, ibuprofen or other nonsteroidal medicines such as Advil, Aleve, Motrin or Pediaprofen should NOT be taken for 2 weeks before surgery unless you are told otherwise. It is okay for most children to take acetaminophen (Tylenol).

Shower or bathe your child the evening before surgery. Makeup, nail polish, contact lenses, earrings or other jewelry, and tampons should be removed before your child arrives at the hospital.

The Day of Surgery

Dress your child in loose clothing. Tight clothing (like jeans or shirts that slip over the head) may be uncomfortable or difficult to wear after some procedures. An extra pair of underwear may come in handy. If your child has long hair, we recommend that it be worn up or away from the face. Remember to bring your child's favorite toy, book, blanket, pacifier or special comfort item. They can take this with them into the operating room. If your child uses a special formula, Playtex bottle, nipple or sippy cup, bring these with you for your trip home.

Because your child having surgery will need your full attention, we request that you do not bring siblings or your children with you if possible. Young children will not be permitted to enter Phase I recovery but will be allowed in Phase II (if indicated).

Preop Reception and Waiting Room/ Check-In

Once you have signed in, your child will be asked to put on a hospital gown. (Yes, they do open in the back!) A staff member will check your child's weight, temperature, blood pressure, pulse and breathing.

Please! No eating or drinking in the Preop Reception and Waiting Room out of respect for our patients who are unable to eat or drink before surgery.

During Surgery

Anesthesia

You will meet your child's anesthesia doctor or nurse anesthetist before surgery. You will have the chance to talk about the medicines that will be used during surgery and for comfort after surgery. You can also discuss concerns you may have about how your child will separate when going into the operating room.

Most children who have surgery receive a general anesthetic. This means the child sleeps deeply enough to not move or feel any pain. Infants and younger children usually fall asleep by breathing the anesthetic through a facemask. (They can choose a flavor for the mask!). Older children may prefer to fall asleep by getting the anesthetic through an intravenous (IV) line. If an IV is used, cream may be applied to numb their skin so it doesn't hurt to start the IV.

After your child is asleep, a breathing tube is usually placed in the airway. This is done to protect the airway, control breathing and maintain sleep during surgery. The tube is removed at the end of surgery and before your child wakes up. An IV may also be inserted during surgery. This will remain in place after surgery for as long as necessary. Fluids and medications can be given through the IV.

Parents or caregivers remain with their child until the time of surgery. The anesthesia doctor or nurse will walk or carry your child into the operating room. Younger children may ride in a wagon.

Family Waiting Room

During surgery, parents and caregivers wait in the Family Waiting Room (behind the door with the Lion) next to the Recovery Room. One family member is required to stay in the Family Waiting Room throughout the procedure. Food and beverages are permitted in this area. Please take advantage of this opportunity to have something to eat especially if you did not eat before arriving. Additional directions to vending areas, the cafeteria or phones can be provided that day.

After Surgery

After surgery, your child will be transported to the Phase I Recovery Room for close observation and care. (Some children are directly admitted from the operating room to the intensive care unit). Your child may awaken quickly or sleep for what seems a long time. As soon as your child is awake, you will be able to visit and stay with him or her in Phase I (only 2 adult visitors at a time in Phase I).

Phase I

Some children continue to need small amounts of oxygen while in Phase I. This is provided by a facemask, nasal tubing (cannula) or by blowing the moisturized oxygen through tubing by the child's mouth and nose. An oxygen monitor will be wrapped around a finger or toe. An IV and blood pressure cuff may be in place. Any special needs from surgery (such as a cast or dressing) will also be present.

Some pain can be expected after surgery. Doctors and nurses will try to keep your child as comfortable as possible. For more information please see our pain management section.

Phase II:

Outpatients

Children going home the same day of surgery (outpatients) are moved from Phase I into Phase II. Clear liquids will be offered and they can watch TV. Discharge instructions will be reviewed with you. Plan on your child being in the Recovery Room (Phase I and II) at least one hour or more.

Children are discharged from Phase II and transported to the parking structure in a wheelchair. Younger children and infants may be carried or ride in a stroller.

Patients for Admission

Children who will be admitted to the hospital after surgery can have parents or caregivers visit in the Phase I Recovery Room. Parents accompany their child as they are moved from Phase I to their hospital room. In Mott Children's Hospital, patient care is family focused so you will be encouraged to help with many aspects of your child's care. Each general care unit offers flexible visiting hours. Some parents choose to "room in" with their child. (This option is not available for moderate or intensive care areas.) Please note that only one person can be accommodated to sleep in the room.