Get ready for surgery

Prehabilitation

Research shows that patients who are fitter before surgery recover faster, have fewer complications, and spend less time in hospital.

Prehabilitation has six main parts:

  • Stop smoking and vaping
  • Breathing exercises (before and, more importantly, after surgery)
  • Reduce alcohol intake
  • Aerobic exercise
  • Strength training
  • Mental readiness

Aim to start at least 4–8 weeks before your operation if you can.

Stop smoking and vaping

This is one of the most important things you can do before surgery. You could lower your risk of a complication by up to 40%. Smoking reduces the oxygen reaching your heart and other vital organs, raises your risk of breathing complications, and slows wound healing. Longer term, it increases your risk of heart disease, lung disease and cancer.

Aim to stop at least 8 weeks beforehand. Even 24 hours helps. If you are ready to quit smoking, Quitline can support you with a plan designed to help you, all for free.

Breathing exercises

Why this matters

Every day, you breathe in bacteria and particles from the air around you. Your lungs clear these continuously using a layer of mucus and millions of tiny hair-like structures called cilia, which work like a moving belt, sweeping debris upward to be coughed out or swallowed.

Anaesthetic medicines and prolonged bed rest temporarily impair this system. Without active steps to compensate, bacteria can build up and cause a chest infection (also called pneumonia). Abdominal and chest surgery adds another challenge: your main breathing muscle, the diaphragm, is held back by pain and surgical trauma, making deep breathing feel difficult.

Up to 50% of patients undergoing major abdominal or chest surgery develop a breathing complication (including chest infections and pneumonia) if breathing exercises are not performed. For non-major operations this is up to 30%.

The good news: starting deep breathing exercises as soon as you wake from anaesthesia significantly reduces this risk. Practise before your operation so you know exactly what to do when it counts.

How to do your breathing exercises

Work through the cycle below. Aim to complete 20 deep breaths per session, and do a session every waking hour after surgery. Before your operation, practise 2 to 3 times a day so it becomes natural.

NORMAL BREATHING BREATHE IN SNIFF & PAUSE HOLD BREATHE OUT Big, slow breath in Sniff! Sniff again! Pause Hold 3–5 sec Let it rush out Cough if needed: press a folded pillow firmly to your wound
One breathing cycle: a big slow breath in, two extra sniffs, a short hold, then let the air rush out. Repeat until you reach 20 breaths.
  1. Take a big, slow breath in through your nose, letting your chest and abdomen expand fully.
  2. Pause briefly at the top, then take two short extra sniffs to fully inflate your lungs.
  3. Hold for 3 to 5 seconds.
  4. Let the air rush out freely. If you feel any phlegm, press a folded pillow or both hands firmly against your wound and have a strong cough.
  5. Repeat until you reach 20 breaths per session.

When to do this

After your operation (this is the most important time): every hour while awake.

Before your operation: 2 to 3 sessions each day to build the habit.

Download: Preventing Lung Problems After Surgery (PDF)

Reduce alcohol intake

Cutting down alcohol lowers the risk of bleeding, infections and heart complications.

Stopping harmful drinking before surgery can lower some complications by up to 75%.

Is your drinking OK? Fill in this quick questionnaire to find out. Extra help and support can be found here.

Aerobic exercise

Activity that raises your heart rate and deepens your breathing. Brisk walking is ideal. Aim for 30 minutes each day, split into shorter blocks if needed (for example, three 10-minute walks). Build up gradually.

Strength training

Exercises to maintain muscle mass. Try 60 to 100 sit-to-stands through the day (sets of 10 to 20 using a chair), plus arm curls with a light weight.
Stop if you feel dizzy or unwell.

Always work within your own limits. It is normal to feel slightly tired or mildly sore as your body adapts. If you experience chest pain, severe breathlessness, or dizziness, stop and seek medical advice.

Mental readiness

Feeling prepared and knowing what to expect reduces anxiety and helps you take an active part in your recovery. Read through the educational information your team gives you, and the guides on this website, so there are no surprises along the way. Simple relaxation or breathing techniques, a regular sleep routine, and arranging help at home before you come in all support a calmer, smoother recovery.

Eating well before surgery

Nutrition

Good nutrition in the weeks before your operation helps your body prepare for the physical stress of surgery and supports faster healing afterwards.

  • Eat regular meals with a good source of protein at each one (meat, fish, eggs, dairy, legumes, or tofu).
  • Eat plenty of vegetables and fruit to provide vitamins and minerals that support healing.
  • Stay well hydrated. Aim for 6–8 glasses of water per day. Limit sugary drinks and excessive caffeine.
  • Try to maintain a healthy weight. If you are significantly underweight or have lost weight recently, tell your surgical team. You may benefit from nutritional support before your operation.

Fasting before surgery reduces the risk of complications during anaesthesia.

  1. 6 hours before surgery

    Stop eating solid food. You may continue to drink clear fluids. No milk, smoothies, or fizzy drinks. You can chew gum but make sure to spit it out before going into theatre.

  2. 2 hours before surgery

    Stop all fluids, including water, black tea or coffee, and clear juice.
    Many hospitals now use sip 'til send. This means you can have up to 200ml of water per hour until the time you go through to theatre. Please ask the nurses who call you regarding this.

  3. Some hospitals provide a carbohydrate drink

    Your team may give you a carbohydrate loading drink (such as Preload or similar) to take 2 hours before surgery. This reduces thirst, hunger, and post-operative nausea. Follow your team's specific instructions.

Always follow the specific fasting instructions from your surgical or anaesthetic team. These take priority over the general guide above, particularly if you have diabetes or a condition affecting stomach emptying.

Protein is the building block your body uses to heal wounds, rebuild muscle, and fight infection. In the weeks before surgery, aim to eat more protein than usual.

  • Target: 1.2–1.5 grams of protein per kilogram of body weight per day. (For a 70kg person, that is 85–105g per day.)
  • Good food sources: chicken, fish, eggs, Greek yoghurt, cottage cheese, lentils, chickpeas, tofu, and nuts.
  • Protein supplement drinks (e.g., Fortisip, Ensure, Complan) can be helpful if your appetite is poor or you are struggling to eat enough. These are available from pharmacies without a prescription.

If your surgical team recommends specific nutritional supplements, take these as directed. Tell your team if you are finding it difficult to eat enough. Nutritional support services are available.

Alcohol

Stop drinking alcohol at least 4 weeks before surgery. Alcohol increases bleeding risk, impairs wound healing, suppresses immune function, and affects how your body responds to anaesthesia and pain relief.

Smoking

Stop smoking as early as possible, ideally 8 weeks before surgery. Smoking significantly increases the risk of wound infection, chest complications, blood clots, and slower healing. Your GP can help with cessation support.

Herbal supplements

Stop all herbal and natural supplements at least 2 weeks before surgery. Many affect bleeding or interfere with anaesthetic drugs. This includes: garlic capsules, ginkgo biloba, ginseng, St John's Wort, kava, valerian, and high-dose fish oil.

Grapefruit

Avoid grapefruit and grapefruit juice in the week before surgery. Compounds in grapefruit block a liver enzyme that breaks down many medications, including some used in anaesthesia and pain management.

Build your prep plan

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