The number of prescribed tests prior to surgery has been reduced in recent years on absolutely necessary findings. Today, not all tests available are carried out each patient. It will take into account individual factors such as health status, age and extent of operation.

Examination before surgery
I support you in planning necessary examinations prior to surgery according to your individual situation. The clarification of your personal health starts with taking your medical history (anamnesis) and a clinical examination.

If it is a minor operation and medical history and clinical examination are unremarkable, no further examinations and tests before surgery become necessary (Austrian Guideline for preoperative patient evaluation of ÖGARI).

If prior medical abnormalities are suspected that may adversely affect surgery, anaesthesia or the postoperative course, further studies need to be performed. Is a major operation planned, further studies are also necessary.

I inform you about necessary examinations and plan with you its timely performance.

The results from the evaluation of your personal health, together with the clinical examination are important for further planning of perioperative treatment and recovery from surgery.

Eating and drinking before surgery
In a situation that you are operated on the same day, you must not take any food or fluid for six hours prior to surgery (stay fasted). Should you not operated until the next day, you are allowed to eat and drink before admission.

Before certain operations a preparation of the gastrointestinal tract through special diets and laxatives becomes necessary. I will inform you about timing and adequate performance of bowel preparation.

Information sheet
During the planning of your operation you will receive more information about diagnosis and planned surgery and you will be asked to sign a personal informed consent sheet for the planned operation.

Blood-thinning medicines are either drugs that inhibit blood clotting, called anticoagulants (low molecular weight heparin or cumarin derivates such as Lovenox® and Marcoumar®) or inhibitors of blood platelet aggregation such as aspirin (ThromboASS®) or clopidogrel (Plavix®). If you are such medication, please let me know during planning your surgery. I will clarify whether these drugs must be discontinued before surgery and whether replacement is necessary by another preparation.

Please note that switching to other drugs or normalization of blood clotting may take two to three weeks and must be monitored by specialist doctors.

Actually, we need to start before surgery to pay attention to your perioperative nutritional demands. Day-long fasting before or after surgery is history. However, no solid food are allowed to eat from six hours before surgery, but, you are allowed to drinks up to 250mls of clear fluid (water or tea) up to two hours before surgery.

A very light meal will be offered to you already six hours after surgery. Nutrients absorbed from the gastrointestinal tract support the complication-free recovery. Depending on the kind and extent of surgery you will be encouraged taking small quantities of food and drink. The diet is increased thereafter according to intestinal function.

After major abdominal surgery will increase by small steps to normal meals by gradually adding carbohydrates, protein and fats in the appropriate ratio.

During the first week after an abdominal operation, light and balanced diet is important. To preserve your well-being, avoid fat-rich or spicy foods.

I am happy to inform you about the proper nutrition before and after surgery and help you in selecting your favorite food that is appropriate for postoperative nutrition.

Nutrition after operations on the pancreas (or diseases of the spleen)

Reported errors in medical diagnosis and treatment are usually based on confusion of important facts or issues, disregard of existing risk factors, insufficient knowledge of the medical situation and lack of safety standards. With a few standard measures the majority of these errors can be prevented. This includes personal contact with the patient, planning the treatment by a multidisciplinary team (if necessary), the use of safety checklists in surgery and the attentive care in the further course of treatment.

Personal contact with patients
In personal conversation, patients can indicate important details from the medical history and provide information about current symptoms and complaints, additional diseases, prescription medications or unclear circumstances. History taking will be supplemented by a physical examination and the exact review of all results obtained so far. This allows to identify risk factors (for example, allergies to medications, anticoagulants) and important information about previous treatments will be obtained.

Interdisciplinary treatment
Nowadays the treatment of a complex disease such as cancer, will have to be considered in many aspects by an interdisciplinary team of specialist doctors (surgery, internal medicine, radiology, etc.). The joint debate on the proper diagnosis and the most appropriate treatment ensures that all treatment options are considered and no inappropriate therapy is prescribed.

Checklists
Nowadays surgical disciplines use modern security measures called safety checklists. The first checklist notes the successful application of many important procedures before surgery: explanation of surgery and anaesthesia to the patient and informed consent, risk of bleeding and reserved supply of blood products, check of blood tests, chest X-ray, marking of the surgical site, reservation of intensive care bed (if necessary), anti-thrombosis medication, identification bracelet. Before the transport into the operating room, all items on the list are checked again for its correct application, the unique identification of the patient, the type and site of the operation, the planned scale of operation, the function of the equipment used in the operation and further details if necessary. The operation begins only, when all questions are positively checked. At the end of the operation, the type of surgery performed, medical conditions and information for the postoperative care are reviewed by the surgical and anaesthesiology team. The surgical instruments and other equipment is checked for completeness.

Personal care after surgery
After an operation, deviations from the normal healing process may sometimes occur. Laboratory results and clinical findings must be controlled during repetitive visits in order to detect complications early in the postoperative course. A medical report at discharge should clearly summarize diagnosis, treatment and further planning.