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Before your operation

Find out what happens before surgery, having an anaesthetic, the people you’ll meet and the exercises you need to do.

Tests to check you are fit for surgery

You have tests before your operation to check:

  • your fitness for an anaesthetic, if you need one
  • that you’ll make a good recovery from surgery

You might have some or all of the following tests:

  • blood tests to check your general health and how well your kidneys are working
  • an ECG to check that your heart is healthy
  • breathing tests (called lung function tests)
  • an echocardiogram (a painless test of your heart using sound waves)
  • a chest x-ray to check that your lungs are healthy

Pre assessment clinic

Your pre assessment appointment prepares you for your operation.

You meet members of your treatment team at this appointment and you can sign the consent form to agree to the operation.

Ask lots of questions. It helps to write down all your questions beforehand to take with you. The more you know about what is going to happen, the less frightening it will seem.

You can ask more questions when you go into hospital so don’t worry if you forget to ask some. At the hospital you might meet:

The surgeon

A member of the surgical team will tell you about:

  • the operation you are going to have
  • the benefits of having surgery
  • the possible risks
  • what to expect afterwards

The anaesthetist

The anaesthetist gives you the anaesthetic and looks after you during the operation. They make sure you’re fit enough for the surgery.

The nurse 

The nurse checks your:

  • general health
  • weight
  • blood pressure
  • pulse
  • temperature

They also check what help and support you have to see what you will need when you go home.

The dietitian

The dietitian gives you help and advice about managing your diet. They:

  • help you get as well as possible before your operation
  • explain how the surgery affects your diet
  • give useful tips on how to increase your nutrients and calories

They might give you nutritional supplement drinks to have before surgery.

Some people need a feeding tube in their stomach or small bowel. This makes sure you get the nutrition you need before your surgery.

The physiotherapist

The physiotherapist assesses how well you can move around. They let the doctors know if there is anything that could affect your recovery.

The physios also teach you leg and breathing exercises to do after your operation to help with recovery. Learning how to do the exercises beforehand makes it easier afterwards.

Learning breathing and leg exercises

Breathing exercises help to stop you from getting a chest infection. If you smoke, it helps if you can stop at least a few weeks before your operation.

Leg exercises help to stop blood clots forming in your legs. You might also have medicines to stop the blood from clotting. You have them as small injections under the skin.

You start the injections before your operation. You might also wear compression stockings.

Your nurse and physiotherapist will get you up out of bed quite quickly after your surgery. This is to help prevent chest infections and blood clots forming.

This 3-minute video shows you how to do the breathing and leg exercises.

The nurse will go through a series of questions on a checklist to make sure you are ready for surgery. They ask you to:

  • tell them when you last had something to eat and drink 
  • change into a hospital gown
  • put on a pair of surgical stockings
  • take off any jewellery (except for a wedding ring)
  • take off any make up, including nail varnish
  • remove contact lenses if you have them
  • put on 2 hospital identification bands usually on each wrist

If you have false teeth you can usually keep them in until you get to the anaesthetic room.

For some types of surgery, you need to shave the skin over the operation area. Or the nurse might shave it for you. They might do this when you’re under anaesthetic in the operating room.

Your nurse might give you a tablet or an injection to help you relax. This will be an hour or so before you go to the operating theatre. This makes your mouth feel dry but you can rinse your mouth with water to keep it moist.

If you've had medicine to help you relax your nurse and a porter take you to theatre on a trolley. You can walk down to the theatre if you haven't had any.

Having an anaesthetic

You have an anaesthetic so that you can’t feel anything during the operation. You have this in the anaesthetic room, next to the operating theatre.

All the doctors and nurses wear theatre gowns, hats and masks. This reduces your chance of getting an infection.

The anaesthetist puts a small tube into a vein in your arm (cannula). You have any fluids and medicines you need through the cannula including the general anaesthetic. This sends you into a deep sleep. When you wake up, the operation will be over.

Before you go to sleep your anaesthetist might put a small tube through the skin of your back. It goes into the fluid around your spinal cord. They can attach a pump to this tube to give you pain medicines during and after the operation.

Last reviewed: 
05 May 2016
  • Guidelines for the management of oesophageal and gastric cancer
    WH Allum and others
    Gut. 2011 Nov; 60(11):1449-72.

    Minimally invasive oesophagectomy 
    NICE interventional procedure guidance [IPG407], September 2011.

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