Having Surgery

Overview

Surgery is a medical procedure where a specially trained doctor (a surgeon) fixes, removes or replaces a part of your body. It may involve a cut in your skin, called an incision, or it may be done through tiny openings using a camera and small tools. Some operations are small and you go home the same day. Others are bigger and you stay in hospital for a while. Some are planned weeks in advance, and some happen suddenly in an emergency. Whatever the reason, you will be given information, asked for your consent, and looked after by a team before, during and after the operation.

Yes. Millions of operations are done every year, and having surgery at some point in life is very common. Hospitals do operations every day, so the staff looking after you are used to guiding people through it step by step.

Anyone can need surgery, from newborns to people in their nineties. What changes with age is the type of operation and how much support you may need afterwards. Children usually need a parent or carer with them, and older adults may need extra help with moving around, meals and medicines for a while.

Symptoms

Common symptoms

• Pain or soreness around the wound, which usually eases over the first few days
• Feeling very tired and needing more sleep than usual for the first week or two
• Swelling or bruising near the wound or in the area that was operated on
• A sore throat or dry mouth after a general anaesthetic, from the breathing tube
• Feeling sick, or constipation from pain relief and less movement
• A smaller appetite and a change in how your bowels work for a few days
• Feeling emotional, teary or easily upset in the first weeks

Symptoms in children

• Being clingy, whingey or wanting to be held more than usual
• Being sleepier than normal, or finding it hard to settle
• Eating and drinking less for a day or two
• Complaining of a sore tummy, headache or feeling sick, even if the operation was elsewhere
• Being afraid of the scar or of going back to hospital
• Young children may behave as if they are younger than they are for a short time

Symptoms in older adults

• Sudden confusion or muddled thinking after an operation, which is more common in older people and should always be reported to the team
• Feeling weaker or less steady on your feet than before, which usually improves with movement and physiotherapy
• A higher chance of chest infections or blood clots, which is why deep breathing and leg exercises matter
• Dry mouth, thirst or poor appetite, sometimes made worse by pain relief
• Needing more help at home for a while after leaving hospital

Causes

Main causes

• To find out what is wrong — for example, taking a small sample of tissue (a biopsy) to test
• To remove something that is causing harm, such as an inflamed appendix, gallstones or a growth
• To repair damage, such as a broken bone, a hernia or a torn ligament
• To replace a part that has worn out, such as a hip joint or a heart valve
• To relieve symptoms that cannot be managed another way, such as a blocked blood vessel or very heavy periods
• To treat an infection, such as an abscess that needs draining
• To treat a serious illness such as cancer, often alongside other treatments

Risk factors

• Smoking, which slows healing and raises the risk of chest and wound infections
• Being very overweight, which increases strain on the heart and lungs and the risk of clots
• Diabetes or high blood sugar, which slows wound healing
• Being frail or having several long-term conditions
• Lung problems, including sleep apnoea (pauses in breathing during sleep)
• Anaemia (a low red blood cell count) or poor nutrition before the operation
• A previous blood clot, or a family history of clots
• Kidney or liver disease
• Medicines that thin the blood, or steroid tablets taken for a long time
• Drinking a lot of alcohol, which can affect anaesthesia and healing
• Emergency surgery, which carries more risk than planned surgery because there is less time to prepare

When to see a doctor

See a doctor urgently if:

• You have a temperature, chills, or the wound looks angrier than it did yesterday
• The wound is leaking pus, smells unpleasant, or will not stop oozing
• Pain is getting worse rather than better after the first few days
• You cannot keep fluids down, are not passing urine, or feel very unwell
• You become breathless, develop a cough, or notice a swollen, painful leg
• You feel confused or unusually drowsy

Book a routine appointment if:

• You have questions about your medicines and whether to stop any before surgery
• You feel anxious about the operation or the anaesthetic and want to talk it through
• Your recovery seems slower than you expected and you want reassurance
• You need a sick note, or advice about returning to work, driving or exercise
• Your mood stays low for more than a couple of weeks
• You want to discuss whether surgery is the right choice for you, or what the alternatives are

Diagnosis

The decision to have surgery is made after talking with you about your symptoms, examining you, and looking at test results. Your doctor should explain why surgery is being suggested, what the alternatives are (including doing nothing or trying other treatments), and what the benefits and risks are likely to be for you. If you go ahead, you will usually have a pre-operative assessment — an appointment to check that you are fit enough for the anaesthetic and to plan your care.

Tests that may be done

• Blood tests to check your blood count, kidney and liver function, blood sugar and clotting
• A heart tracing (ECG) to check your heart rhythm
• A chest X-ray if you have a lung or heart condition
• Scans such as ultrasound, CT or MRI to see the area being operated on
• A urine test, and sometimes a pregnancy test before an anaesthetic
• A swab to check for bacteria that are hard to treat, so they can be cleared up first
• Breathing tests, or a sleep study if you snore heavily or have sleep apnoea
• A review of all your medicines, including anything you buy over the counter and herbal remedies
• A dental check, because unhealthy teeth can raise the risk of infection after some operations

What to expect at your appointment

The assessment usually takes 30 to 60 minutes. You will be asked about your health, your medicines, allergies, previous anaesthetics, and who will be at home to help you. You may be asked to stop smoking, improve your diet, or have treatment for anaemia before the operation, because this makes complications less likely. You will be told when to stop eating and drinking before surgery, what to bring, and where to go. Before the operation you will sign a consent form, and you can change your mind at any point — asking more questions is part of the process, not a delay.

Treatment

Surgery itself is the treatment, and how it is done depends on what you need. Some operations are done through one larger cut (open surgery); others use a camera and thin instruments through small openings (keyhole or laparoscopic surgery), which often means less pain and a quicker recovery. You may be awake with a numb area, relaxed with sedation, or fully asleep under a general anaesthetic. Many operations are day cases, where you go home the same day; others need a stay in hospital.

Self-care at home

• Ask your team about prehabilitation — simple steps before surgery such as building up walking, improving your diet, and cutting out smoking, which help you recover better
• Follow the eating and drinking instructions exactly; usually you must stop food for several hours before an anaesthetic
• Arrange for someone to take you home and stay with you for the first day or two if you are having a day case
• Prepare your home: cook and freeze meals, put everyday items within easy reach, and stock up on pain relief, dressings and a thermometer
• Write down all your medicines and bring the list, or the medicines themselves, to every appointment
• Pack loose, comfortable clothes, slippers with a good grip, phone charger and something to pass the time
• Write down your questions beforehand so you remember to ask them
• Keep moving gently after surgery and do any breathing or leg exercises you are shown — they help prevent chest infections and clots

Medical treatments

During and after surgery your team will manage pain with a plan made for you, which may include tablets, injections or a small tube that delivers pain relief. You may be given antibiotics to treat or prevent infection, medicine to settle sickness, and medicine to reduce the risk of blood clots. You may also see a physiotherapist to help you move safely, a dietitian for advice on eating well while you heal, and specialist nurses for wound care. Many hospitals use an enhanced recovery programme — a set of simple steps that get you eating, drinking and moving soon after surgery, which helps most people home sooner.

When is surgery considered?

Surgery may be suggested when other treatments have not helped enough, when a problem needs to be fixed physically, or when waiting would be risky. Planned surgery can often be timed to suit you, giving you time to prepare; emergency surgery happens when a problem cannot safely wait. It is always your decision whether to go ahead, and your team should support you in weighing up the options.

Living with this condition

The first few days are mostly about resting, taking pain relief as advised, and keeping the wound clean and dry in the way you were shown. You will be given a wound care plan and a follow-up appointment. Ask when you can shower, drive, lift, have sex and go back to work — the answers vary a lot depending on the operation. Keep a note of any questions and any changes you notice so you can raise them at your review.

Lifestyle tips

• Follow the lifting limits you are given — lifting too much too soon is a common cause of set-backs
• Build activity slowly, starting with short walks and gradually doing more each day
• Avoid smoking and keep alcohol to a minimum while you heal
• Take care of your scar: keep it out of strong sun and use any cream your team recommends once the wound is fully closed
• Do not drive until you can brake safely and concentrate comfortably, and check with your insurer and surgical team
• Ask for help with shopping, cleaning and childcare — accepting help is part of recovery, not a failure

Diet and exercise

Eating well helps you heal. Include protein at each meal — beans, lentils, eggs, fish, chicken, dairy or tofu — along with fruit and vegetables. Drink plenty of water, and eat high-fibre foods such as wholemeal bread, oats and fruit to prevent constipation, which is common after surgery and pain relief. Gentle movement matters: short walks, plus any breathing and leg exercises your team gives you, help your lungs, your circulation and your mood. Build up gradually and stop if something hurts sharply.

Mental health and emotional wellbeing

It is completely normal to feel anxious before an operation and flat, tearful or impatient afterwards. Some people feel shaken for weeks, especially after a big operation or a stay in intensive care, and some have intrusive thoughts or trouble sleeping. These feelings usually ease, but they are worth mentioning to your GP or surgical team rather than carrying them alone. If you ever feel you cannot keep yourself safe, or you have thoughts of harming yourself, contact your local emergency number or a crisis line straight away — help is available and you deserve it.

Prevention

Not all surgery can be avoided, and sometimes it is the safest and kindest option. But you can lower your chance of problems around an operation. Stopping smoking several weeks beforehand, keeping active, eating well, controlling blood sugar, getting anaemia treated and looking after your teeth all help. Choosing when to have planned surgery means you have time to prepare — use it.

Vaccines

Check that your routine vaccinations are up to date, and ask your surgical team whether any vaccines need to be timed around your operation. Some vaccines are best given well before or after surgery rather than in the days around it. Flu and COVID-19 vaccinations are safe for most people and reduce the risk of chest infections; your pharmacist or GP can advise.

Screening programmes

Screening programmes can pick up problems early, when treatment may be simpler and less invasive. Depending on your age and where you live, this may include screening for bowel, breast or cervical cancer, and checks for conditions such as high blood pressure and diabetes. If you are invited for screening, it is worth taking up the offer, and you can ask your GP which programmes apply to you.

Complications

If left untreated

• The problem may get worse over time, sometimes becoming harder to treat
• Pain or loss of function may increase and affect work, sleep and independence
• An infection or inflammation could spread and cause serious illness
• Some conditions, such as a blocked blood supply or a burst appendix, can become life-threatening
• Emergency surgery may then be needed, which carries higher risks than planned surgery

Long-term outlook

Most people recover well from surgery and notice real improvement in the problem that led to the operation. Recovery takes time — weeks rather than days for bigger operations — and it is normal to feel tired and frustrated along the way. Serious complications are uncommon, and the checks before your operation are designed to catch problems early. Keep in touch with your team about anything that worries you, and be patient with yourself: steady, gentle progress is exactly what healing looks like.

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