Being told you need laparoscopic surgery — whether for an ovarian cyst, fibroids, endometriosis, a diagnostic laparoscopy, or a hysterectomy — raises a predictable set of questions. What tests do I need? When do I stop eating? Which medicines do I keep taking and which do I stop? What should I bring to the hospital? What will the day actually look like?

These questions are completely reasonable and deserve complete answers. Poorly prepared patients have longer hospital stays, higher complication rates, and more anxiety on the day. Well-prepared patients recover faster, feel more in control, and have fewer surprises.

Dr. Shachi Singh, consultant laparoscopic surgeon at Prakash Hospital, Sector 33, Noida, provides this complete pre-operative guide for women undergoing gynaecological laparoscopy.

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The Pre-Operative Appointment: What Happens Before Surgery Day

In the 1 to 2 weeks before your scheduled surgery, a pre-operative assessment appointment will cover:

1. Clinical review: Your surgeon confirms the surgical plan, discusses what is expected to be done, and reviews your medical history for any factors that might affect anaesthesia or surgery.

2. Informed consent: You will be asked to sign a consent form. This is not a formality — it is an important conversation. Read it carefully. Ask about anything you do not understand. Consent for laparoscopy typically includes consent for conversion to open surgery if laparoscopy is not safely possible (rare, but you should know it is a possibility), and consent for any treatment (cyst removal, endometriosis excision, adhesiolysis) that may be performed at the same sitting if found during diagnostic inspection.

3. Blood tests: Standard pre-operative bloods include complete blood count (haemoglobin, platelets), blood group and crossmatch, kidney function, liver function, blood glucose, coagulation screen (clotting time). Some surgeons add a pregnancy test — confirm with your surgeon.

4. ECG (electrocardiogram): Routinely done for women over 40 or those with any cardiac history, to assess cardiac function before general anaesthesia.

5. Chest X-ray: Occasionally required depending on your medical history and the anaesthetist's assessment.

6. Anaesthetic review: Your anaesthetist will review your medical history, current medications, allergies, previous anaesthetic experiences, and any relevant risk factors. Disclose everything — every medication including supplements and herbal preparations, all allergies, previous reactions to anaesthesia.

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Investigations You May Need to Bring

Depending on what has already been done as part of your diagnostic workup, your surgeon may need to review:

• Recent pelvic ultrasound reports and images
• Previous blood test results (CA-125 if indicated, hormonal profile, culture results)
• Any previous operative reports or hysteroscopy reports
• MRI if done for complex endometriosis or fibroid mapping

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Medications: What to Stop and What to Continue

This is one of the most important aspects of pre-operative preparation. The guidance varies by medication type:

Stop before surgery:

1. Blood thinners and anticoagulants: Warfarin, aspirin (unless prescribed for specific cardiac or pregnancy reasons — check with your cardiologist/obstetrician), clopidogrel, rivaroxaban, dabigatran. These must be stopped before surgery to reduce bleeding risk. The timing varies (warfarin typically 5 days before, newer anticoagulants typically 24 to 48 hours — your surgeon and the prescribing doctor will coordinate). Do not stop these on your own without specific guidance.

2. NSAIDs (ibuprofen, diclofenac, naproxen): Stop 5 to 7 days before surgery — these impair platelet function and increase surgical bleeding risk.

3. Herbal and Ayurvedic supplements: Many herbal preparations affect clotting (garlic, ginger, ginkgo, turmeric at supplement doses), liver metabolism, or anaesthesia. Stop all herbal supplements at least 2 weeks before surgery and disclose them to your anaesthetist.

4. Hormone therapy and oral contraceptive pill: The OCP increases blood clot risk postoperatively. Your surgeon may advise stopping it 4 to 6 weeks before elective surgery, particularly for longer procedures. Discuss this with your surgeon — it is not always required for brief laparoscopic procedures.

Continue as normal (unless specifically told to stop):

• Blood pressure medications (antihypertensives) — usually continued up to and including the morning of surgery with a small sip of water
• Thyroid medication (levothyroxine) — take as usual
• Insulin and diabetes medications — specific instructions from your surgeon (blood glucose management around surgery requires individual planning)
• Epilepsy medications — continue; discuss with your neurologist
• Psychiatric medications — most are continued; discuss with your prescribing doctor

The rule: Never stop or continue any medication on assumption. Ask explicitly, and get confirmation in writing or from a named person at the surgical team.

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Fasting: When to Stop Eating and Drinking

This is critical for anaesthetic safety. Aspiration of stomach contents during induction of general anaesthesia is a serious complication — fasting eliminates the risk.

Standard fasting guidelines:

• Solid food: Stop 6 hours before the planned surgery time. This includes all food, sweets, milk, and milky drinks.
• Clear fluids (water, clear juice without pulp, clear tea without milk, black coffee): Stop 2 hours before surgery.
• Medications on the morning of surgery: Take with a small sip of water (15 to 30 mL) even during the fasting period, if your anesthetist confirms this.

Calculate from the planned surgery time, not from when you wake up. If surgery is at 2 PM, stop solid food at 8 AM. If surgery is at 8 AM, stop solid food at midnight and stop all fluids at 6 AM.

If surgery is delayed (which can happen), do not eat or drink while waiting for updated instructions — contact the ward to ask when you can take fluids again.

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Bowel Preparation

For gynaecological laparoscopy, full bowel preparation is not routinely required (unlike colon surgery). However:

• Avoid heavy, high-fibre meals the day before surgery to reduce bowel gas during the procedure
• Some surgeons recommend a glycerine suppository the evening before for procedures near the bowel (deep endometriosis, rectovaginal work)
• Your surgeon will give specific instructions if bowel preparation is indicated for your procedure

Eat light, easily digestible food the day before: rice, dal, curd, light khichdi, boiled vegetables. Avoid pulses, cabbage, cauliflower, and other gas-producing foods.

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Hygiene and Physical Preparation

1. Bathing: Shower or bathe the evening before and the morning of surgery if time permits. Clean skin reduces surgical site infection risk.

2. Skin around the operative area: Shaving of the pubic area is sometimes done in the theatre or is no longer required in many centres (clipping rather than shaving is preferred). Do not shave or wax at home the day before — this creates micro-abrasions that increase infection risk.

3. Nail polish and jewellery: Remove all nail polish (fingers and toes) — the pulse oximeter used during anaesthesia reads through the fingernail and polish interferes with the reading. Remove all jewellery including rings, earrings, and piercings. Leave valuables at home.

4. Makeup and perfume: None on the day of surgery. No moisturisers, lotions, or deodorant on the surgical area.

5. Contact lenses: Remove before surgery. Bring your glasses.

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What to Wear and Bring

Wear: Loose, comfortable clothing that is easy to put on after surgery when your abdomen may be tender. Front-opening tops work well. Flat shoes — heels are not appropriate for a post-surgical walk to the car.

Bring to hospital:

• ID and all hospital registration documents
• Your pre-operative blood test and ECG reports if done outside the hospital
• Any imaging (ultrasound, MRI) on CD or print
• A list of all medications you take (including doses)
• Your anaesthetist's pre-op instructions in writing
• A trusted companion — you cannot drive yourself home after general anaesthesia and need someone with you for at least the first 24 hours
• Basic toiletries if you may stay overnight
• Do not bring large amounts of cash or valuables

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Arranging for Recovery at Home

Planning your home recovery before surgery is often overlooked and then urgently needed afterward.

Arrange in advance:

• Someone to accompany you to and from the hospital — you cannot drive for at least 24 to 48 hours after general anaesthesia, and longer if the procedure was significant
• Someone to be with you at home for the first 24 to 48 hours at minimum
• Light, easily prepared food in the house for the first few days
• Any help with children or household responsibilities for the first week
• Leave from work — for a standard diagnostic or operative laparoscopy, most women need 5 to 7 days; for more extensive procedures (myomectomy, hysterectomy), plan for 2 to 4 weeks

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Questions to Ask Before Surgery

Before signing consent and going to the theatre, make sure you have clear answers to:

• What exactly will be done? What is the surgeon looking for and what may be treated?
• What is the expected operating time?
• Will I stay overnight or go home the same day?
• When can I eat and drink after surgery?
• When can I return to normal activities / work / driving?
• What pain relief will I have after surgery?
• What are the specific warning signs I should watch for at home?
• When is my follow-up appointment?

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Laparoscopic Surgery at Prakash Hospital, Noida

Dr. Shachi Singh at Prakash Hospital, Sector 33, Noida, performs laparoscopic gynaecological surgery for women across Noida and Greater Noida — including ovarian cyst removal, myomectomy, diagnostic laparoscopy, LOD for PCOS, endometriosis excision, and laparoscopic hysterectomy.

To book a pre-surgical consultation with Dr. Shachi Singh, call: +91 97023 46853

Clinic Hours: Monday to Saturday, 9 AM – 6 PM | Sunday, 10 AM – 2 PM

Clinic Address: D-12A, 12B, Sector-33, G.B. Nagar, Noida, Uttar Pradesh 201301

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Frequently Asked Questions

1. How many hours before surgery should I stop eating?

6 hours before the planned surgery time for solid food (including milk). 2 hours before for clear fluids. Count from the planned surgery time, not from when you wake up.

2. Can I take my blood pressure tablet on the morning of surgery?

Most antihypertensives should be taken on the morning of surgery with a small sip of water. Confirm this specifically with your anaesthetist — do not assume either way.

3. Do I need to shave before laparoscopic surgery?

Do not shave or wax at home before surgery — micro-abrasions increase infection risk. Any necessary hair removal near the incision sites is handled in theatre by trained staff.

4. Can someone stay with me in the hospital?

Policies vary by hospital. One attendant is typically permitted to stay with the patient in the ward or private room. Confirm the specific policy with Prakash Hospital's admissions team.

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This blog is written for educational and informational purposes only. Please follow the specific pre-operative instructions given by Dr. Shachi Singh and the anaesthetic team, as these take precedence over general guidance.