Surgery Preparation. Know before you go.
Why preparation matters
Surgery with Dr. Dunn is a collaborative process, and it starts well before you arrive at the hospital. Patients who follow preparation instructions carefully tend to have smoother procedures, fewer complications, faster recoveries, and better outcomes. It's not just protocol. It's how you set yourself up for the best result.This guide applies to most laparoscopic procedures performed at NorCal Integrity Surgery, including anti-reflux surgery, hiatal hernia repair, LINX, gallbladder removal, and hernia repair. If you've been scheduled for a more complex procedure (esophageal surgery, colon surgery, or abdominal wall reconstruction), Dr. Dunn's team will give you a personalised pre-op plan at your pre-operative appointment.
When in doubt, call us. If you're ever unsure whether a medication is safe to take, whether a symptom before surgery is concerning, or what to do in any situation not covered here — call the office at (408) 688-5871. Dr. Dunn's team is there to help you.
What to do and when
Preparation happens in stages. Starting too late creates unnecessary stress, and missing a step can result in your surgery being postponed for your safety. Some details depend on your specific procedure, so follow the guide Dr. Dunn's team sends you. Work through this timeline from the moment your surgery is confirmed.
Confirm your surgery date, time, and arrival instructions with Dr. Dunn's team. Arrange a responsible adult to drive you home and stay with you for the first 24 hours. If you smoke, stop now, since smoking significantly affects healing and anesthesia. If you have children, pets, or significant household responsibilities, arrange help for 1 to 2 weeks after surgery while you have time.
Stop taking aspirin and NSAIDs (like ibuprofen or naproxen) 5 days before surgery. Stop taking blood thinners (warfarin, rivaroxaban, apixaban) 3 days before surgery, or as directed by your prescribing doctor. Keep taking your reflux and antacid medications as usual. Avoid alcohol for at least 48 hours before surgery.
Your recovery diet depends on the exact procedure you are having, so follow the dietary guide Dr. Dunn's team sends you and shop for those items now. In general, eat lighter meals in the days leading up to surgery, since heavy, fatty meals can increase nausea under anesthesia.
Nothing to eat after midnight. This is the most important rule and is non-negotiable, since food in your stomach during general anesthesia creates a serious aspiration risk. You may continue taking essential medications (heart, blood pressure, seizure) with a small sip of water, as directed. Keep taking your reflux medication as usual.
Clear liquids (water, black coffee without cream, apple juice) are permitted up to 4 hours before your scheduled arrival time, not before your surgery time. Follow any procedure-specific instructions from Dr. Dunn's team. Shower using regular soap, and do not apply lotion, cream, perfume, or deodorant. Remove all nail polish, jewellery, piercings, and contact lenses. Wear comfortable, loose-fitting clothes (an elastic waistband is recommended).
What to stop — and what to keep taking
Medication management before surgery is one of the most important, and most misunderstood, parts of preparation. Never stop a medication without checking with Dr. Dunn's team first. Some need to be stopped; others must not be stopped.
Stop before surgery
- Blood thinners: warfarin, rivaroxaban (Xarelto), apixaban (Eliquis), clopidogrel (Plavix). Stop 3 days before, or as directed by your prescribing doctor.
- Aspirin and ibuprofen (NSAIDs). Stop 5 days before.
- Herbal supplements: fish oil, vitamin E, garlic, ginkgo, ginseng. Stop 1 to 2 weeks before.
- Weight loss injections (GLP-1 medications like Ozempic or Wegovy). Stop 1 week before.
Continue taking
- Heart medications (beta-blockers, calcium channel blockers) — continue as prescribed
- Blood pressure medications — continue with a small sip of water the morning of surgery
- Thyroid medications — continue as directed
- Seizure medications — do not stop; take as prescribed
- Inhalers for asthma — bring to the hospital and use as directed
Always confirm with Dr. Dunn's team before stopping any medication. This list is a general guide. Your specific medications, dosages, and conditions may require different instructions. If you are seeing multiple doctors or specialists, let our team know your complete medication list at least 1 week before your surgery date.
What to bring on the day
Keep it simple. You do not need much and most valuables should be left at home. Here is exactly what to bring and what to leave behind.
Bring these
- Government-issued photo ID (driver's licence or passport)
- Your insurance card
- Complete list of all current medications and dosages (written or on your phone)
- Any inhalers or essential medications you use daily
- Your phone and charger
- Comfortable, loose-fitting clothes with elastic waistband
- Slip-on shoes (bending may be uncomfortable post-surgery)
- A small bag with a change of clothes if you're staying overnight
Leave at home
- Jewellery, watches, and rings
- Contact lenses (bring glasses instead)
- Nail polish (the monitoring equipment reads through your nails)
- Lotion, perfume, or heavy deodorant
- Large amounts of cash
- Laptop or tablets (leave at home unless overnight stay)
- Children they cannot wait in most surgical facilities
Your driver and support person
Do not drive yourself home after general anesthesia, even if the surgery was short or you feel fine. We recommend arranging a responsible adult to drive you home and stay with you for the first 24 hours. If you are not able to arrange a driver, let us know. The hospital can help arrange a ride home so you are never stuck. Either way, plan to have someone with you during the first day after surgery.
Preparing your home before you leave
Coming home from surgery feeling comfortable starts with setting up your space the day before. A few simple preparations make the first week significantly easier, and mean you won't have to ask someone to go shopping while you're recovering.
For GERD / hiatal hernia / anti-reflux surgery specifically: Stock liquid and soft foods for a full two weeks, not just a few days. You will be on a restricted diet longer than for other procedures. Dr. Dunn's team will give you a specific diet progression guide at your pre-op appointment.
Notes for your specific procedure
While the general preparation steps above apply to most surgeries, each procedure has specific nuances. Here are the most important additional notes for the most common procedures performed by Dr. Dunn.
Anti-Reflux / Hiatal Hernia
- Stop reflux medication (PPI / omeprazole) the evening before surgery
- You can eat what you like in the days before surgery. No special diet is needed beforehand.
- Stock two full weeks of soft and liquid foods at home
- You will receive a detailed diet progression guide at pre-op
- Plan for 1–2 weeks before returning to desk work
Gallbladder Removal
- No special bowel preparation required
- Low-fat diet recommended for 1–2 days before surgery
- Most patients go home same day arrange to leave hospital by early evening
- Stock low-fat foods for the first 2 weeks at home
- Most patients return to desk work within 5–7 days
Hernia Repair
- No special bowel preparation for laparoscopic inguinal or ventral hernia repair
- Avoid lifting anything over 10 lbs in the week before surgery (the hernia can worsen)
- Arrange for someone to help with physical tasks for 2 weeks post-surgery
- No heavy lifting or strenuous activity for 4–6 weeks post-surgery
Colon Surgery / Complex Procedures
- Bowel preparation (bowel prep) is typically required you will receive specific instructions
- Clear liquid diet the day before surgery
- You will likely stay 1–3 nights in hospital pack accordingly
- Plan for 4–6 weeks before returning to physical work
- Coordinate with Dr. Dunn's team for detailed, personalised instructions
What happens on the day
Knowing exactly what to expect when you arrive helps reduce anxiety considerably. Here is a step-by-step walkthrough of a typical surgery day at NorCal Integrity Surgery.
Arrive at the designated facility at your scheduled time (typically 2 hours before surgery). You will check in, complete any remaining paperwork, and be taken to the pre-operative area.
A nurse will review your medications, check your vital signs, place an IV line, and prepare the surgical site. The anesthesia team will meet with you and explain the anesthesia plan. Dr. Dunn will stop in to confirm the procedure and answer any last-minute questions.
General anesthesia is administered, you will be fully asleep and feel nothing. Most laparoscopic procedures take 1–2 hours. Complex procedures may take longer. Your support person will be updated in the waiting area.
You will wake up in the Post-Anesthesia Care Unit (PACU), where nurses monitor your vital signs and manage any pain or nausea as you come round from anesthesia. This typically takes 30–90 minutes. Pain is usually mild to moderate and managed with IV medication.
For most laparoscopic procedures, you will be discharged the same day once you are awake, stable, have tolerated sips of fluid, and can walk safely. Your driver will bring the car around. You will receive written discharge instructions and a phone number to call with any concerns.
Common Questions
