Your safety is our primary outcome

Choosing to have surgery is a significant decision. My role as your surgeon is to ensure that when we step into the operating theatre, every possible variable is tilted in your favour.

"Readiness" isn't just about having a hernia or gallstones; it’s about Optimisation. Using data-driven insights, we identify any factors—from BMI to cardiovascular fitness—that we can improve before surgery to ensure your recovery is as smooth and rapid as possible.

The Optimisation Pillars

  • The Data: Research shows that smokers have a significantly higher risk of mesh infection, hernia recurrence, and chest infections post-surgery.

    The Advice: For the best result, I recommend a "clear window" of at least 4 weeks before surgery. This isn't about judgment; it’s about ensuring your tissues have the oxygen levels they need to knit back together perfectly.

  • The Data: If your HbA1c is above 64 mmol/mol (8.0%), the risk of post-operative infection increases.

    The Advice: If your blood sugars are running high, we will work with your GP to optimize your control before the procedure. Bringing your sugars into the "Green Zone" before surgery is the single most effective way to ensure a "one-and-done" surgical result.

  • The Data: Being on a blood thinner (like Warfarin, Apixaban, or Rivaroxaban) is a common clinical factor and is not a barrier to surgery.

    The Advice: We don't just "stop" these medications. We create a bespoke "Bridging Plan" based on your specific risk profile. During your consultation, we will map out exactly when to pause and when to restart your medication to ensure your safety throughout the journey.

Surgical Readiness Assessment

Utilising validated clinical markers to ensure you are medically optimised for surgery.

Can you climb a flight of stairs or walk up a hill without stopping?
Can you run a short distance?
Can you do heavy housework, like scrubbing floors or lifting heavy furniture?
Can you participate in strenuous sports like swimming, singles tennis, or football?
Do you snore loudly?
Do you often feel tired, fatigued, or sleepy during the daytime?
Has anyone observed you stop breathing during your sleep?
Is your Body Mass Index (BMI) greater than 35?
Are you a current smoker or do you vape?
Do you have Diabetes with an HbA1c reading greater than 64?
Are you currently taking blood thinners or anticoagulants?

Surgical Readiness Passport

Mr Saqib Rahman PhD FRCS

Consultant Biliary & Hernia Surgeon

Wessex Nuffield Hospital
Private Practice Service
Patient: Date:
1. Clinical Risk Profile

Estimated Functional Capacity: METs (Threshold > 4.0)

Anaesthetic Risk (STOP-BANG): / 5

2. Optimisation Requirements
3. Summary

Medical Data Note: This report is a clinical synthesis of patient-reported metrics using the Duke Activity Status Index (DASI) and STOP-BANG screening. Functional capacity (METs) is a key predictor of perioperative outcomes.

In my research, I’ve found that the best surgeries are won before we ever enter the theatre. By calculating your functional capacity (METs), we move from 'gut feeling' to 'clinical precision.' If your score is lower than we'd like, don't worry—it just means we will tailor your anaesthetic plan and post-operative monitoring to ensure your treatment is as low risk as possible.