Preoperative and postoperative treatment of the gynecologic patient

The gynecologic practice has seen an increasing expansion into the field of endoscopy, with a marked decrease in postoperative complications. Patients are having surgery on an outpatient basis with small incisions, decreased medication requirements, and rapid ambulation. However, we must still be prepared to treat patients for whom this newer technology is not indicated. With our increasing longevity will come an increase in the population of patients who will be at increased operative risk. Many recent reports have centered on the need for careful patient selection and education, preoperative laboratory and radiologic evaluation, and medical prophylaxis. The surgeon must be sure that reasonable low-risk evaluation and care has been taken preoperatively to avoid intraoperative and postoperative morbidity and mortality.