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Tests before the operation
  1. Urine analysis to avoid any possible hazard of infection (all patients).
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  2. Blood analysis which should include liver and kidney function tests, electrolytes estimation, fasting blood sugar  level, coagulation tests (Quick test), Cholesterol level and blood picture (all patients).
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  3. Electrocardiogram (ECG) for patients above 40 or those who have a previous history of heart disease.
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  4. Lung function test (spirometry) for smokers and patients above 40 or those who have a previous history of lung disease.
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  5. Radiology of the thorax (x-ray in two dimensions) for smokers and patients above 40 or those who have a previous
    history of heart or lung disease.
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  6. Medical clearance letter from the physician (all patients above 40 in a good health and any patient with a history of previous heart, lung, liver or kidney disease, diabetes mellitus or elevated blood pressure).

The last three tests (3,4,5) are important for the choice of the anesthesia and its technique.

All patients must be seen at least 24 hours before the surgery. The details of the surgery and its indications are explained. The results of the pre operative examination will be reviewed. The consent of release to surgery is then undersigned. The patient is examined also by the anesthetist who will discuss with him the procedure and its hazards and will take his signature on the consent for anesthesia.