Preparing For Surgery: Preoperative Studies

Many people do not realize that there are a great number of things that need to occur well in advance of the day of surgery. There are a number of tests, exams and studies that need to be performed before the big day. As the complexity of surgery increases, the need for more studies in advance also increases. Also, if a patient has other medical conditions, these need to be addressed and corrected as much as possible before surgery.

Since an increasing number of surgeries are being performed laparoscopically, i.e. using small incisions and cameras, instead of large incisions, surgeons must know the precise anatomy well in advance. Therefore, do not be surprised if you need to have some X-rays, a CT scan and MRI or some other radiographic study. Your surgeon will want to use these studies to get an accurate picture of your unique anatomy, but also the extent of disease and how it has changed your body. Obviously this will not be necessary for routine surgeries such as appendectomies, but for more technically challenging surgeries like joint, brain or heart surgery, expect several radiographical tests to be done.

 

Surgery can be quite stressful to the heart so if there is any indication or history of heart disease, that will need to be fully explored by the day of the procedure. Whether or not there is a known history of heart disease, most patients will need an EKG (electrocardiogram) ahead of time. The purpose of this is twofold. One, it can show if there is any evidence of heart disease of which the patient is not aware or has not been detected by other tests. Two, it can provide the surgeon and anesthesiologist a baseline reading to which they can compare EKG readings that will be taken during surgery. In cases where a patient’s heart may be a concern, occasionally a cardiac stress test will be ordered. A cardiac stress test evaluates how the heart respond to a stress, either by having the patient exercise for a period of time, or by administering a medicine that stimulates the heart. During this test the physician can get a good idea of how the patient’s heart will perform during the stress of surgery.

Certain blood tests will be performed before the day of surgery. These are routine and provide information about the kidneys, lungs and liver function. Tests will also be done to make sure that you are able to form blood clots appropriately. If your blood is abnormally thin, you will not be able to have surgery until this is corrected because of the increased risk of serious bleeding.

Specific surgeries have some tests that are unique to them. For example, for a surgery to remove a potentially cancerous tumor, a blood test to detect that certain tumor will be performed before surgery. With this value in hand, your doctors will expect the number to go down after the surgery. Also, the values before and after surgery can be used to make sure the cancer does not return and take more informative steps in the event that it does return.

These studies give you an idea of most of the preoperative information that doctors and surgeons gather before surgery. It serves to remind the reader that a lot of preparation goes into surgery both inside and outside of the operating room.