Planning and preparation

Tuesday 1 April, 2014

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  On this page: Pre-assessment | Understanding the risks | Possible complications | Informed consent | Frank's story | Getting ready for surgery | Preparing for surgery | Key points


There are things you can do before surgery to make the process easier. Some of these include: 
  • having the required pre-assessment tests
  • understanding the risks and possible complications, and giving your signed consent
  • following your health professionals’ specific instructions about how to prepare for your operation.

Pre-assessment

Your medical team will determine if you are fit enough to have an operation. If you have another serious health condition, such as a heart problem, you may not be able to have an operation. Your doctor will look at your medical history and do tests or scans. This is the normal process for anyone preparing for an operation.

Waiting for surgery

It’s common to have to wait to have surgery. The length of time depends on many factors, including the type of cancer you have and its stage, the operation you are having and the hospital. In most cases, the waiting time doesn’t have a significant impact on the outcome of the operation. You may want to use the waiting time to read more about the procedure and organise things at home to make your recovery easier. If you are anxious or concerned, speak to your surgeon. 

"I waited just over three weeks from diagnosis to surgery. I was happy to slot in with the surgeon – and I think they would have scheduled it sooner if the cancer had been aggressive." – Page

Understanding the risks

 Almost all medical procedures have risks, and surgery is no exception.

The length of the operation and type of anaesthesia you have are important factors to consider, as are your age and general health.

Although advances in surgical techniques have made surgery safer, there are still things that may not go as planned and possible complications. Overall, you and your surgeon should feel that the expected benefits outweigh the possible risks.

Possible complications

This section has some information on the most common complications that may occur during and after surgery. It’s very unlikely that all of these would be relevant to your situation. Your surgeon can give you a better idea of your actual risks. Generally, the more involved the surgery, the more likely there could be complications. Nonetheless, it’s unlikely these will be life-threatening. 

During surgery

Bleeding: You may lose blood during surgery – this is called controlled blood loss. Uncontrolled bleeding is a problem that surgeons must manage, but it’s rare for this to occur.

Damage to other tissue: Most organs are tightly packed together, so working on one part of the body can affect nearby tissue. This may affect the function of other organs after surgery – for example, handling the bowel may cause you to be temporarily constipated.

Drug reactions: In rare cases, some people react badly to anaesthesia or other drugs used. This can be serious because it can cause a drop in blood pressure, heart rate and breathing. Tell your doctor if you’ve had any previous reactions to herbal or prescribed medication, no matter how small the reaction.

After surgery

Infection: There are some simple ways to prevent a wound from becoming infected. Sometimes the doctor will prescribe medication before surgery to help prevent infection (prophylactic antibiotics), and you will be monitored for fever, which shows that your body is fighting off an infection. Not all wounds become infected. 

Tip: Protect yourself against infection by trying to ensure the things you come into contact with are clean. Try to avoid people who are unwell, practise good hygiene and change dressings regularly.

Blood loss (haemorrhage): Your medical team will manage any post-surgery bleeding. This could include giving you transfusions or doing further surgery to stop any bleeding in severe cases.

Lung problems: If you had abdominal surgery, it may be temporarily painful to breathe or cough. You will be encouraged to do deep breathing exercises, and get out of bed to move around. Your medical team will monitor your breathing during your recovery.

Effects of being less mobile for a prolonged time: All surgery and some cancers increase the risk of developing blood clots in the legs or pelvis (deep vein thrombosis or DVT). Preventive measures include wearing special stockings, injections of anti-clotting drugs, and using devices to keep the calf muscles moving during and sometimes after the operation.

Although you’ll need to rest after surgery, it’s important to get up and move around. If you aren’t mobile, your muscles may get weak (atrophy). A nurse or physiotherapist may help you move around as soon as possible and give advice about the best exercises to do. Generally, the sooner you are able to get up and move, the better. 

If you are bedridden for a long time after surgery, you may require rehabilitation in order to help you get safely back on your feet and return home. 

Other problems: Surgery puts your body under stress. After an operation, some people have irregular heartbeats, kidney problems or other complications. These problems are more likely to affect older patients who have pre-existing conditions. Reading about the possible complications may be confronting, but it’s extremely unlikely that everything listed above would be relevant to you. Talk to your surgeon about your situation. 

Informed consent

A doctor needs your agreement (consent) to perform any medical treatment. Adults can give their consent – or refuse it – if they have capacity. Capacity means they can understand the information about the proposed choices and make reasonable decisions based on this information.

Sometimes consent is not needed, such as in a medical emergency. However, if your operation is planned, your doctor will talk to you about the benefits and risks. Receiving and understanding this information before agreeing is called informed consent. See your rights for more information.

"Hearing about risks and complications was full-on, but I wanted to know everything that could happen." – Kathleen

Frank's story

"When my mum was diagnosed with bowel cancer, the medical team recommended she have a right hemicolectomy to remove the affected parts of her bowel.

"Before surgery, we went to the hospital to see the surgeon for the pre-assessment appointment. My wife and I went along to provide support and help mum understand the surgeon’s instructions.

"The surgeon talked to the three of us about the potential risks and benefits of the hemicolectomy. Mum’s elderly and she had heart problems a few years ago (three stents), so she takes low-dose aspirin daily. The doctor explained the risks of bleeding during the operation, and told mum to stop taking aspirin for a week before the operation.

"Even though it was stressful to ‘download’ all the medical information and instructions, the pre-assessment actually eased our minds. I walked away knowing that although it’s a major operation, very few people die. And I knew the practical things we had to do to help mum prepare.

"On the day of surgery, we all felt nervous but ready. Mum was in theatre for a while, but she got through the operation without any problems. Over time and with the dietitian’s help, she resumed eating.

"When I look back, I think Mum was calmer than us. It can be really stressful and nerve-wracking to be the support person for someone having surgery. We found it helpful to ask the medical team questions about what was happening so we felt in control and knew how to look after her."

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Getting ready for surgery

You will have to prepare for the operation. Your surgeon or medical team will review your records and plan the procedure. They’ll take into account your health, including any allergies you have, and give you instructions about how to prepare. Follow their direction and let them know if you have any concerns with what you are asked to do.

Stockings: Your legs may be measured for stockings to reduce the chance of developing a blood clot in your veins.

Blood samples: You may have some blood taken in the days before the operation, and on the day of the procedure.

Shower and shave: You should bathe before the operation. You might be instructed to do so the day before, not on the operation day. If you have hair near the operation site, it may be shaved.

Eating and drinking: Most people are told not to eat or drink for 6–12 hours before the operation so their digestive tract is empty. This may be called fasting or nil by mouth.

Medication: If you’re instructed to take medication, such as a laxative, swallow tablets with only one mouthful of water. Avoid taking aspirin or other blood-thinning medication for 1–2 weeks before surgery to lessen the risk of bleeding – if you are taking aspirin under medical advice, discuss it with your surgeon. 

Support person: You may want to ask a support person to wait in the waiting room. You should plan ahead and arrange someoneto escort you home when you are discharged from day surgery. It’s not safe to travel alone or use public transport or a taxi, as you will still be under the effects of the anaesthetic. The hospital social worker can help organise transport if necessary.

Preparing for surgery

This list provides a general guide about what you may want to bring to day surgery. Talk to your medical team about what to bring or ask the hospital for a list. You may need more supplies if you are recovering in hospital as an inpatient.

What to bring
  • A support person, if possible
  • Forms or letters from your doctor, and any recent x-rays or scans
  • Medicare card and/or private health care information
  • Medications you are taking in their original packaging
  • Any essential equipment you already use, such as a portable oxygen machine, mobility aids or hearing aids
  • Reading material and reading glasses
  • Comfortable, loose-fitting clothes
  • Toiletries, if you want to freshen up afterward, if you need sanitary items or if you are staying in hospital to recover
What not to bring
  • Valuables, including jewellery
  • Large sums of cash and credit cards
  • Make-up and nail polish
  •  Hair clips and pins, unless you are an inpatient
  • Food and drink – most patients are asked not to eat or drink before the operation
  • Contact lenses (for day surgery)
  • Sleepwear/pyjamas (for day surgery) – a hospital gown is provided. If you are staying in hospital to recover, it’s okay to wear your own comfortable clothing
  • Personal items, such as a hot water bottle 

Key points

  • Your medical team will determine if you are fit enough to have an operation by doing some tests and scans and looking at your medical history. This is known as a pre-assessment.
  • Some people with other serious health problems or complications (such as a heart condition) can’t have an operation.
  • It’s common to have to wait to have surgery. Your waiting time depends on whether the operation is in a public or private hospital and how urgent your case is.
  • There are risks associated with surgery. Generally, the longer and more complex the procedure, the higher the risk.
  • Your doctor will discuss possible complications that may occur during and after surgery. This may include bleeding, infection and drug reactions. The risks will depend on your specific situation. It’s uncommon to have life-threatening complications.
  • The surgeon needs your agreement (consent) to perform the operation. Receiving relevant information about the benefits and risks of surgery before agreeing to undergo the procedure is called informed consent.
  • Before the operation, you may need some additional tests, such as blood tests.
  • The surgical team will give you instructions about preparing for the operation. This will include a list of what to bring on the day of the operation, and some guidelines about what to leave at home. 


Reviewed by: Dr Bronwyn Avard, Deputy Director, Intensive Care Unit, The Canberra Hospital and Senior Lecturer, ANU Medical School, ACT; Kylie Foley, Registered Nurse, Urological, Gynaecological and Vascular Surgery, Royal North Shore Hospital, and Practice Nurse, Hills Family General Practice, NSW; Di Holt, Consumer; Shelly Hunter, Physiotherapist, Brisbane Private Hospital Rehabilitation Unit, QLD; Lorraine Kealley, Registered Nurse, Medical Oncology Ward, Royal Perth Hospital, WA; Shomik Sengupta, Urologist, Sengupta Urology, VIC; Dr BP Wheatley, Retired Generalist Obstetrician and Gynaecologist, SA; Carmen Heathcote, Yvonne Howlett and Amy Parker, Helpline Operators, Cancer Council Queensland.
Updated: 01 Apr, 2014