Pre-surgical evaluation
An evaluation of the general health status is needed before any surgical procedure can be performed. Especially the cardiovascular system and the pulmonary function have to be evaluated in order to assess the risks in regard to surgery. To date, there is no general standard or consensus on the needed pre-surgical evaluation, therefore, these can vary from centre to centre.
As the risk for certain types of cancer is higher in obese patients, it is important to consider also this in the pre-surgical evaluation.
Besides medical examination, often psychological or psychiatric evaluations are also required. This is important to assess the capability of the patient to cope with the surgery and its long-term consequences (e.g. changes of the body image, follow-up). If necessary, a psychological therapy should be taken into account as supportive treatment.
Before surgery, existing comorbidities have to be treated as good as possible in order to minimize the operative risk.