Questions to ask before surgery

The best questions before surgery are not polite filler. They are how you find out whether the operation is necessary, what it is expected to change, what could go wrong, what happens if you wait, and what recovery will really demand. Good consent is not just signing a form: it is a shared decision based on benefits, alternatives, material risks and what matters to you.¹

Questions that decide whether surgery is right

Start with the decision, not the diary date. The first question is: "What problem is this surgery trying to solve?" A knee replacement for severe arthritis, bowel surgery for cancer, gallbladder removal for recurrent gallstones and spinal surgery for nerve compression all have different decision logic. If you do not know the main goal, you cannot judge success.

NICE shared decision-making guidance says people should be supported to discuss options, benefits, harms and what matters to them.³ That means you can ask for numbers where they exist: expected chance of improvement, chance of no benefit, chance of needing another procedure, and how your age, weight, smoking, diabetes, frailty, medicines or previous surgery change risk.

Ask what happens if you wait. Some operations are time-sensitive. Others can be delayed while you try physiotherapy, medicines, weight change, injections, watchful waiting or another specialist opinion. The safest answer is not always surgery now, and it is not always delay. It depends on risk, symptoms, disease progression and your priorities.

Second opinions are reasonable when the operation is major, irreversible, high risk, preference-sensitive, or when two clinicians have described the problem differently. A second opinion does not mean the first surgeon is wrong. It means the decision deserves more confidence. Ask whether the opinion should come from the same department, a different hospital, a subspecialist centre, or a clinician who offers a different technique. If the answer is defensive rather than explanatory, pause. Clarity is part of care.

Questions about risk and complications

Every operation has general risks and operation-specific risks. General risks include bleeding, infection, blood clots, anaesthetic complications, pain, scarring and delayed recovery. Operation-specific risks might include nerve damage, leak, implant failure, stiffness, infertility, incontinence, swallowing problems, voice change, hernia recurrence, non-union, persistent pain or need for revision surgery.

GMC guidance uses the concept of material risk: a risk is material if a reasonable person in your position would likely attach significance to it, or if the doctor knows you would attach significance to it.² For example, a small risk of voice change may matter hugely to a singer, and a small risk of hand numbness may matter hugely to a surgeon, musician or carer.

Ask for absolute risk when possible. "Rare" and "common" mean different things to different people. A 1 in 20 risk of persistent numbness, a 1 in 100 risk of infection, and a 1 in 1,000 risk of life-changing complication feel different when applied to your work, caring role or sport. If numbers are not known, ask how the team monitors outcomes and what complications they see most often.

Questions about surgeon, hospital and technique

Ask who is doing the operation and who is supervising if a trainee is involved. Training is normal in the NHS, but you are allowed to understand the setup. Ask whether the operation is routine for that team, whether it should be done in a specialist centre, and whether there are outcome data, audit data or registry data that apply.

For some procedures, technique matters: open versus keyhole, robotic versus laparoscopic, mesh versus non-mesh, cemented versus uncemented implant, repair versus replacement, local versus general anaesthetic, day case versus inpatient. Do not ask "which is best?" in the abstract. Ask "which option is best for my anatomy, diagnosis, risk factors and goals?"

NICE perioperative care guidance emphasises preparation, shared decision-making, optimisation before surgery and clear discharge planning.⁴ That means questions about smoking cessation, anaemia, diabetes control, nutrition, exercise, weight, alcohol, sleep apnoea and medicines are not side issues. They are part of surgical risk reduction.

Questions about anaesthetic and medicines

Anaesthetic risk is not one-size-fits-all. NHS information explains that general anaesthesia makes you unconscious for an operation and can have side effects such as nausea, sore throat, shivering, confusion or aches, with serious complications uncommon but possible.⁵ Ask whether general, regional, spinal, epidural, sedation or local anaesthetic is planned, and why.

Bring a complete medicine and supplement list. Include anticoagulants, antiplatelets, insulin, diabetes medicines, steroids, HRT, contraception, antidepressants, epilepsy medicines, blood pressure tablets, herbal products, painkillers and recreational substances. Ask what to stop, what to continue, what to restart, and who gives the instruction. Do not guess with blood thinners, steroids, insulin or epilepsy medicines.

Ask about pain control before the operation. Which pain medicines will be used? Are opioids likely? Do you need laxatives? What level of pain is expected? What pain should trigger concern? How do you taper pain medicines? Pain plans are easier to make before you are sleep-deprived and sore.

Questions about recovery and aftercare

Recovery is where vague advice causes trouble. NHS surgery guidance advises following the healthcare team's instructions after surgery and explains that recovery depends on the operation and individual health.⁶ Ask for specific restrictions: driving, work, lifting, stairs, showering, swimming, sex, sport, travel and childcare.

Ask who to call. The answer should not be "your GP" for every problem. Some issues belong to the surgical ward, some to the consultant secretary, some to emergency care, some to physiotherapy and some to the GP. Before discharge, get phone numbers and red flags in writing.

Use the health library to understand your condition, and insights when you are comparing evidence for an operation. If medicines, supplements or anticoagulants are part of the plan, the stack builder can help prepare a clean list for the pre-op assessment.

What to ask your GP or surgeon

If you are unsure whether the operation is right, say so before the day of surgery. A good surgeon would rather answer questions early than discover on the morning that you are confused or unwilling. If you need help turning worries into a focused appointment list, Start here.

The purpose of these questions is not to interrogate the surgeon. It is to make the decision real. Surgery is easier to consent to, recover from and evaluate when everyone understands the same goal, the same risks and the same plan. Write the answers down before memory blurs later.

This article is educational and does not constitute medical advice, diagnosis, or a treatment recommendation. Medication uses described as “off-label” are not licensed for that purpose in the UK and should only be considered under qualified clinical supervision. Always speak to your GP, pharmacist, or a registered specialist before starting, stopping, or changing any treatment. If you have severe or alarm symptoms - unintentional weight loss, blood in your stool, difficulty swallowing, persistent vomiting, a fever, or severe pain - seek urgent medical care.