Having a Laryngectomy

Your operation will be carried out under a general anaesthetic which means that you are fully unconscious for the whole operation. Because having a laryngectomy involves delicate surgery the operation can last between 5 - 12 hours.

To prevent vomiting and other complications during the operations it is necessary for you to starve (have nothing by mouth or no chewing gum) for at least 6 hours before the operation. You will be advised of what time to starve from when you attend the pre-admission assessment.

You should expect to be in hospital for at least 2 - 3 weeks or longer if complications arise.

The main problem following a laryngectomy is wound infection or poor healing. This can delay normal eating and drinking as the wounds need to be fully healed so that food and drink can enter the stomach and not the tissues in the neck.
A small tract from the windpipe into the new gullet (called a fistula) can sometimes develop. This needs longer healing time and prevents you taking any food or drink by mouth. There is no immediate operation for this it just needs more healing time.

Bleeding is a risk after any operation and you will be closely observed for this following your surgery. You and your family will be fully informed of any problems.

After any major operation there is a risk of:

• Chest Infection... You can help by practicing deep breathing exercises and following the instructions of the physiotherapist. If you smoke, it is a good idea to stop smoking as far ahead of the operation as possible as this will also reduce the risk of chest infection.
• Wound Infection... Antibiotics will usually be given through a drip to help reduce the risk of this happening.
• Thrombosis (Blood clot in the leg)... This is due to changes in the circulation during and after surgery. A small dose of heparin (blood thinning medication) may be injected daily until you go home. You can help by moving around as much as you are able and in particular regularly exercising your legs.
  You may also be fitted with some support stockings for the duration of your stay in hospital. Stopping smoking may also help reduce this risk.
• Pulmonary embolism... Rarely a blood clot from the leg can break off, travel through the heart and get stuck in the lungs. This can be very serious and, rarely, even fatal. The risk of this is less than 1% (1:100).
• Bleeding... This is monitored after the surgery and any abnormal bleeding will be dealt with by the medical staff.
• Smoking... Most hospitals now adopt a No Smoking policy and there are no smoking facilities on the ward. If you do smoke it is in your own health interests to stop smoking for at least 24 hours prior to your anaesthetic.

Following your operation you will be unable to smoke as you will not be able to draw in from a cigarette. It is in your best interests to start a giving up smoking programme and the staff at the hospital can help you with this or you can seek advice from your GP’s surgery.

Please bring nightwear, day wear, dressing gown, towels, toiletries, slippers, books/magazines and a pen. It is important that you bring any medication you are currently taking, including any inhalers. It will also be helpful to arrange for a relative or friend to wash your nightwear etc and bring in fresh supplies. Hospital nightwear is available if necessary.

Please DO NOT bring any valuables such as jewellery or large sums of money with you. The hospital cannot take responsibility for your valuables. On your admission you will be asked to sign a disclaimer for any valuables you may have with you, accepting your responsibility. Valuables may be taken for temporary safe keeping, by the ward staff, while you have your operation and you will be issued with a receipt.

When you have been taken to your bed the nurse will welcome you and check your details. It is necessary for you wear a theatre gown for your operation. This will be given to you by the nurse and she will instruct you how to wear it and give assistance if required.

Please only wear cotton pants/ underpants under your gown. All other underwear must be removed to provide safety in the use of equipment in the operating theatre.

You will also be given a pair of white elastic stockings to wear during and after the operation which will help to prevent blood clots in your legs. They will feel quite tight to wear and the nurses will help you put these on.
You may need to have your neck shaved before the operation. This may be done in the theatre.

Just before going to theatre a checklist is completed by the nurse. You will then be taken on you bed to the operating theatre usually by a porter and a nurse. Dentures, glasses and hearing aids can be taken out in the anaesthetic room and taken back to the ward by the nurse or you may like to put them in your locker before the your operation.

Here the anaesthetist will insert a small needle into the back of your hand through which you will receive the anaesthetic. The nurse will stay with you until you are fully under the anaesthetic and fully asleep. You will be in the theatre for most of the day. You will not wake up until the operation is over and you are back on your bed in the recovery area. You will then be taken back to the ward, on your bed, by a porter and a nurse.