Preparing for Surgery
A step-by-step guide to help you and your family get ready — physically, practically, and emotionally.
Your Road to Surgery
Being told you need surgery can feel overwhelming. But being well-prepared makes a real difference — to your safety, your recovery, and your peace of mind. This guide explains everything that typically happens in the days before a planned operation, and why each step is done. The process described here reflects standard good practice in surgical care worldwide.
Your Journey — From Diagnosis to Theatre
Step 1 — Understanding Your Investigations
Before any surgery is planned, your surgical team needs to be absolutely certain about what they are dealing with. Every test answers specific questions: Where is the problem? How large is it? Has it spread? Is your body fit for this operation?
🔭 Colonoscopy
A camera test of the large bowel. It allows direct visualisation of any abnormality, a small tissue sample (biopsy) to be taken, and the exact location to be mapped. A biopsy is often the only way to confirm whether something is cancerous. Learn more on our Colonoscopy page.
🖥️ CT Scan
A detailed three-dimensional picture of the inside of your body. It assesses the size and position of the problem and checks whether nearby structures or lymph nodes are involved.
🧲 MRI
Uses magnetic fields instead of X-rays, giving finer detail of soft tissues — especially useful for rectal, pelvic, and sphincter-related conditions.
☢️ PET-CT Scan
A small amount of radioactive tracer lights up areas of unusual cell activity — used to check whether a cancer has spread to distant parts of the body, and to guide the decision about surgery.
Preparing for your PET-CT: You will be asked to fast for 4–6 hours before the scan (water is usually allowed). Avoid strenuous exercise for 24 hours before. If you have diabetes, your team will give specific instructions about your medication. On the day, wear warm, comfortable clothing with no metal. The scan itself takes about 30–45 minutes. You will receive an injection of a small amount of radioactive sugar (tracer) and rest quietly for about an hour before the scan begins.
🩸 Blood Tests, ECG & Chest X-ray
Blood tests check your overall health — including blood counts, kidney and liver function, clotting ability, and markers such as CEA. An ECG and chest X-ray give a baseline of your heart and lungs and identify any conditions that need managing before anaesthesia.
No single test tells the complete story. Your surgeon reviews all results together before making a surgical plan. If you are unsure about any test that has been requested, ask your team to explain its purpose.
Step 2 — The Pre-Anaesthetic Check (PAC Clinic)
Before any planned surgery under anaesthesia, you will be assessed by an anaesthetist. This appointment is called a PAC (Pre-Anaesthetic Check) or pre-operative assessment.
Why it matters
Anaesthesia is extremely safe — but not without risk in patients with heart conditions, diabetes, kidney disease, high blood pressure, or those on multiple medications. The anaesthetist's role is to identify these factors early, treat them where possible, and plan around them — so your anaesthesia is as safe as it can be.
What happens at the PAC
You will be asked about your full medical history, previous surgeries, allergies, and every medication you take — including supplements and over-the-counter medicines. The anaesthetist will examine you briefly, review your blood tests, ECG, and scans, and may request additional tests. This is your opportunity to ask questions about anaesthesia.
Many patients have personal, religious, or cultural concerns that are entirely valid and should be discussed openly at the PAC appointment — not on the morning of surgery, when it is difficult to find solutions at short notice.
These may include:
- A kada, bangle, or sacred thread (mauli, janeu) worn continuously for religious reasons
- A turban or religious head covering that cannot normally be removed
- Concerns about hair removal near the operation site (hair clipping is standard practice and can be discussed)
- Dietary restrictions — vegetarian, vegan, halal, or other — that may affect nutritional preparation
- Preference for same-sex clinical staff during examination or preparation, where possible
- Any other personal or spiritual matter that affects your comfort or wellbeing
The anaesthetic and nursing team are experienced in working sensitively around such concerns. In many cases, practical solutions exist — for example, a metal bangle may be taped securely in position, or a sacred thread covered and protected. The key is to raise these early so that solutions can be planned in advance and no one is placed in a difficult position on the day of surgery.
Step 3 — Medicines Before Surgery
Some of your regular medications may need to be adjusted before surgery. This is standard practice worldwide. Never stop or change any medicine on your own — your surgical or anaesthetic team will give you personalised guidance based on your specific medicines and procedure.
- Blood pressure tablets (most)
- Thyroid medication
- Antidepressants & anxiety medicines
- Epilepsy medication
- Inhalers (asthma / COPD)
- Heart rate tablets (e.g. beta-blockers)
- Diabetes tablets (metformin, etc.)
- Insulin — dose may need adjustment
- Steroids (prednisolone, etc.)
- ACE inhibitors (ramipril, enalapril)
- Water tablets (diuretics)
- Immunosuppressants
- Warfarin & other blood thinners
- Aspirin (unless cardiac stent)
- Clopidogrel, ticagrelor
- Rivaroxaban, apixaban, dabigatran
- Ibuprofen, diclofenac (NSAIDs)
- Herbal supplements (garlic, fish oil, ginkgo, ashwagandha, Ayurvedic preparations)
⚠️ This table is for general guidance only. Always follow the specific advice given to you by your surgical or anaesthetic team. Never stop a medication without being told to do so.
Why blood thinners are stopped
Medicines such as warfarin, aspirin, and clopidogrel reduce the blood's ability to clot. During surgery, controlling bleeding depends on normal clotting. These medicines are paused beforehand — the exact timing depends on the drug and the procedure.
Why diabetes medicines need adjustment
Blood sugar tends to shift around the time of surgery — due to fasting, the stress of the operation, and the effects of anaesthetic drugs. Both tablets and insulin often need dose adjustments. The goal is stable blood sugar — neither too high nor too low — throughout the operative period.
Herbal and Ayurvedic preparations
Several commonly used herbal products — including garlic tablets, fish oil, ginger, ginkgo biloba, ashwagandha, and triphala — can affect bleeding or interact with anaesthetic agents. It is routine practice to stop these before surgery. Always tell your team everything you take, even if it feels minor.
Step 4 — Fasting Before Surgery
You will be asked to stop eating and drinking for a set period before your operation. This is one of the most important safety measures in surgery — without exception.
Why the fasting window exists
Solid food is stopped first — solids take several hours to empty from the stomach. Your team will give you an exact cut-off time based on your operation schedule.
Clear fluids are stopped closer to surgery — plain water, clear tea, or black coffee (no milk) are generally permitted until a shorter time before. Again, follow your team's exact instructions.
Your operation window — by this point your stomach should be empty, making anaesthesia much safer.
Why fasting is essential
Under general anaesthesia, your body's normal protective reflexes are temporarily switched off — including the reflex that prevents stomach contents from entering the lungs. If the stomach is not empty and vomiting occurs under anaesthesia, the contents can enter the lungs, causing a serious and potentially life-threatening condition called aspiration pneumonitis. Fasting eliminates this risk. It is not a formality — it is a critical safety measure.
Step 5 — Bowel Preparation (if required)
For certain operations involving the large bowel, you may be asked to take a bowel preparation — a medically prescribed laxative solution that clears the bowel completely. Not all operations require this — your surgeon will tell you whether it applies to you.
Why it is done
Operating on a bowel that contains stool carries a higher risk of infection if the bowel is opened during surgery. A clean, empty bowel is safer to work with and reduces the chance of contamination. The rationale is straightforward: a clean field leads to a safer operation and a lower risk of post-operative infection.
What to expect
Bowel preparation typically involves drinking a prescribed solution over several hours the day before surgery. You will need to stay close to a bathroom. You may feel bloated or have cramping — this is expected and temporary. Keep yourself hydrated with permitted clear fluids throughout.
Skin preparation
You may be advised to shower or bathe with an antiseptic wash the night before and on the morning of surgery. This is a standard, internationally practised measure to reduce bacteria on the skin near the incision site. It is not a reflection of personal hygiene — it is routine surgical safety.
Step 6 — The Day Before Surgery
The day before your operation is for final, calm preparation — practical and personal.
- Comfortable, loose clothing — easy to put on after surgery
- Toiletries (soap, toothbrush, comb)
- All current medications in original packaging (or a complete written list)
- Investigation reports, scan discs, X-rays requested by your team
- Any consent or admission forms already signed
- A notebook and pen — for questions and information
- Glasses, hearing aid, or walking aid if used
- A trusted person to accompany you
- Small amount of cash for essential needs only
- Jewellery — rings, earrings, necklaces, bracelets
- Nail polish or artificial nails (affect monitoring equipment)
- Hair pins, clips, and hair extensions
- Expensive mobile phones or electronic devices
- Large amounts of cash
- Heavy perfume or body lotion
- Contact lenses — wear glasses instead
- Any items of sentimental value that cannot be replaced
If you wear a kada, bangle, sacred thread, or any item of deep religious significance that cannot normally be removed, and this has not yet been discussed with your team, please contact your surgical team or ward nurse before admission. In many situations, practical solutions can be arranged — such as securing a metal bangle with tape or carefully protecting a thread. What is most important is that this is communicated in advance, not at the last moment.
Rest and sleep
Anxiety the night before surgery is entirely normal and expected. Try to rest as much as you can. Avoid heavy exercise. If you are finding it very difficult to sleep or are feeling severely distressed, speak to your surgical team. There are options available to help, and your emotional wellbeing matters as much as your physical preparation.
Confirm your arrangements
Double-check your reporting time, which entry or ward to go to, and confirm that someone is arranged to be with you. Surgery requires a responsible adult to be present, both for support and to receive information from the team after your operation.
Step 7 — Day of Admission
Everything is coming together now. Here is what to expect when you arrive.
Arrive on time
Surgical lists are carefully scheduled. Arriving late can affect not just your operation but those of other patients. If you are running late for an unavoidable reason, call ahead.
What happens on arrival
The nursing team will check your identity, confirm the planned procedure, check your vital signs (blood pressure, pulse, temperature, oxygen levels), verify your fasting status, and place an IV line (cannula) in your arm. Consent for surgery will be confirmed or signed if not already completed.
Meeting the anaesthetist
If you have not met the anaesthetist at a PAC appointment, you will meet them now. Mention any concerns about anaesthesia, any allergies, or any past experience with anaesthesia — positive or negative. This is the time to speak up.
Consent
Before any operation, you will be asked to confirm your informed consent. This is not a formality. It means you have been explained the nature of the operation, its purpose, likely benefits, and possible risks — and you agree to go ahead. Ask every question you have before signing. This is your right and it cannot be rushed.
Preparation for theatre
You will change into a theatre gown. The operation site may be marked by the surgeon — this is a standard international safety practice to confirm the correct site. Hair near the incision may be clipped (clipping rather than shaving with a razor is associated with lower infection risk).
Your accompanying person
They will be guided to a designated waiting area. They should remain available and reachable throughout. After surgery, the surgical team will speak with them about how the operation went and what to expect next.
Step 8 — Anaesthesia: What to Expect
Most colorectal and cancer operations are performed under general anaesthesia — you are fully asleep and feel nothing during the operation. Some procedures may use regional anaesthesia (a spinal or epidural), where you are awake but the lower body is numb. The anaesthetist will explain what is planned for you.
Going to sleep
Anaesthesia is induced through your IV drip. A medication puts you to sleep within seconds. Most patients describe the experience simply as drifting off — there is no discomfort. You will not be aware of anything during the operation.
During surgery
The anaesthetist monitors you continuously throughout — your breathing, oxygen levels, blood pressure, heart rate, and depth of anaesthesia — adjusting medications in real time to keep you stable. You are never left unattended.
Waking up
You will come around in a recovery area, with nursing staff present. It is normal to feel groggy, confused, cold, or emotional at first. A mild sore throat from the breathing tube is common and temporary. Pain after surgery is actively managed — you do not need to simply endure it. Tell the recovery nurse immediately if you are in pain.
Step 9 — Discharge Planning & Follow-up
Planning for going home begins before your surgery — not on the day of discharge. Safe recovery at home requires preparation, and some arrangements take time to put in place.
Before your surgery, think about:
Who will take you home? You cannot drive or travel unaccompanied after a general anaesthetic. A responsible adult must be with you for the journey.
Who will be with you at home? For the first 48–72 hours after surgery, you should have someone at home with you — particularly for the first night. If you live alone, speak to your surgical team about what support can be arranged.
Your home environment. If you live in a multi-storey home, think about whether you can manage stairs in the first few days after surgery. If you have young children, elderly dependants, or pets that require care, arrange support in advance. Small practical details make a big difference to recovery.
Time off work. Depending on the type of operation, you may need several days to several weeks away from work. The nature of your work matters — desk work differs from physical labour. Arrange this with your employer early and, if needed, ask your surgical team for documentation.
Your follow-up appointment
After surgery, a follow-up visit is scheduled — typically in the clinic — to review your recovery, check your wound, and discuss results including pathology if a tissue specimen was sent for analysis. This appointment is important and should not be missed.
⚠️ Do not wait for your follow-up date if you develop fever, a wound that looks red, swollen, or is leaking, unusual or worsening pain, difficulty eating or drinking, or any other concern that does not feel right. Contact your surgical team promptly.
Pathology results
If a specimen was sent to the laboratory during surgery, results typically take several days to a week. These will be discussed with you at your follow-up. Your surgeon will explain what the results mean for your next steps — whether that is observation, additional treatment, or a referral to another specialist.
Long-term follow-up for cancer patients
For patients treated for colorectal or other cancers, follow-up continues for several years after surgery. This includes periodic blood tests, imaging, and endoscopy on a structured schedule. This programme is designed to detect any recurrence at the earliest possible stage — when it is most treatable. Attend all scheduled appointments even if you feel completely well.
Read more about recovery on our Recovery After Surgery page, and about stoma care on our Living with a Stoma page.
Questions Worth Asking Before Surgery
No question is too small. A well-informed patient tends to recover better — and asking questions is your right, not an inconvenience to your surgical team.
Your surgeon will explain the specific procedure planned for you — including how it will be performed (open or keyhole), which part of the body is involved, and what will be removed or repaired. Every operation is different, and the details depend on your diagnosis, scan findings, and overall health. If anything is unclear, ask your surgeon to explain it again — there is no such thing as a silly question.
After most abdominal and colorectal operations, you may have one or more of the following: an intravenous drip (IV line) for fluids and medicines, a urinary catheter to drain the bladder, and occasionally a surgical drain near the operation site. These are temporary. The nursing and surgical team will remove each one as soon as it is no longer needed — usually within one to three days, depending on the procedure and your recovery.
For certain bowel operations — particularly those involving the rectum or lower colon — a stoma (an opening on the abdomen for bowel output) may be required. Your surgeon will discuss this possibility with you before surgery. In many cases, a stoma is temporary and can be reversed after a few months once healing is complete. In some situations, a permanent stoma may be the safest option. The stoma care team will support you fully, from the first day onwards.
Hospital stay varies depending on the type of operation. Minor procedures (such as haemorrhoid surgery) may require only a day or overnight stay. Major abdominal or cancer operations typically involve four to seven days in hospital, sometimes longer if recovery is slower than expected. Your team will give you an estimate before surgery, but the actual stay depends on how well you recover — particularly your ability to eat, drink, and move around comfortably.
Some pain or discomfort after surgery is expected and normal. Modern pain management is very effective. You may receive a combination of intravenous painkillers, oral tablets, and in some cases a regional block (epidural or local anaesthetic wound infusion). The goal is to keep you comfortable enough to breathe deeply, move, and eat — all of which help recovery. Always tell the nursing staff if your pain is not controlled. Do not wait for it to become severe before speaking up.
After minor procedures, you can usually eat and drink the same day. After major abdominal surgery, you will start with sips of water and progress to light meals as your bowel begins to recover. This typically takes one to three days. Your team will guide you step by step. Eating early — even small amounts — is encouraged as it helps the gut recover and reduces the length of hospital stay.
This depends on the type of surgery and the nature of your work. After minor surgery, many patients return to light activities within one to two weeks. After major abdominal surgery, most patients need four to six weeks before resuming full activity, and sometimes longer for heavy physical work or driving. Your surgeon will advise you based on your specific procedure. As a general rule: you should be able to perform an emergency stop comfortably before driving, and you should not lift anything heavier than a kettle of water in the first few weeks.
Your surgeon will review all your investigation results (blood tests, scans, biopsy reports) before surgery. If there is anything that affects the surgical plan, you will be informed. If you have not heard back about a specific test, it is perfectly reasonable to ask. You should also feel free to request a copy of your reports for your own records.
Before leaving hospital, your team will give you a contact number for the surgical ward or clinic. If you experience fever, wound redness or discharge, increasing pain, difficulty eating or drinking, or anything that does not feel right — call this number. Do not wait for your follow-up appointment if you are worried. It is always better to call and be reassured than to wait and risk a complication going unnoticed.
A follow-up appointment is usually scheduled for one to two weeks after surgery. This may be at the outpatient clinic or, in some cases, a telephone consultation. At this visit, your wound will be checked, your recovery assessed, and any pathology or biopsy results discussed. If you have not been given a follow-up date before discharge, ask the nursing team to confirm one. This appointment is important and should not be missed.
For appointments or enquiries: Contact Dr. Rajeev Kapoor | drrajeevkapoor.com
