Preparing for surgery: take an active role in your recovery
Personalised prehabilitation for patients from Winchester, Southampton and across Hampshire
Waiting for an operation can leave you feeling that all you can do is wait. Prehabilitation offers a way to use that time: improving your fitness, supporting your nutrition and addressing medical problems that may affect your preparation and recovery.
At The Institute of Survival, our medically supervised programme brings together exercise, physiotherapy, nutrition and medical assessment. We help you prepare from your current starting point, whether you have cancer, a long-term condition, reduced mobility or concerns about coping after surgery. You do not need to be fit to begin.
Our programme complements your hospital’s surgical and anaesthetic care. It does not replace hospital preoperative assessment or clearance for surgery, and preparation should never delay necessary treatment.
What is prehabilitation?
Prehabilitation means preparing your health and physical function before treatment. A programme may combine aerobic and strength exercise, nutritional support, attention to medical conditions and help with the practical or emotional challenges of surgery.
The Centre for Perioperative Care states: “Preoperative assessment must be used as the starting point for a process of optimisation and prehabilitation”. Our approach starts with assessment and turns the findings into a personalised plan. Read the CPOC guidance on assessment and optimisation.
Can preparing for surgery improve outcomes?
Research suggests that prehabilitation can improve recovery and reduce complications in some surgical settings.
In the PREHAB randomised trial, published in JAMA Surgery in 2023, 251 people having colorectal cancer surgery were studied. Four weeks of supervised exercise, nutrition and psychological support reduced severe complications: 17.1% with prehabilitation compared with 29.7% with standard care—an absolute difference of 12.6 percentage points. Read the PREHAB trial.
A 2025 systematic review in The BMJ, covering 186 randomised trials and more than 15,000 participants, found that exercise, nutrition and combinations including exercise may reduce complications and hospital stay and improve physical recovery. However, the certainty of much of the evidence was low or very low. Read the systematic review.
These results support preparation, but benefits vary by operation, health and programme. Our service has not been tested in these trials, and we cannot promise the same results or a complication-free recovery.
How our programme matches evidence-based interventions
Exercise to build capacity. Research programmes commonly include aerobic activity and resistance training. We translate these into supervised exercise tailored to your symptoms, abilities and operation. This may involve walking or cycling, strength work and practical movements such as standing from a chair. We progress activity according to your response.
Physiotherapy to address movement difficulties. Pain, previous injuries and limited mobility can make preparation harder. Physiotherapy helps us adapt the plan, address functional limitations and practise movements relevant to daily life and recovery.
Nutrition to support preparation. Multimodal prehabilitation studies include nutritional assessment and support. We consider appetite, unintentional weight loss, protein and overall energy intake, with practical advice suited to your health. Preparing for surgery is not automatically a weight-loss programme; maintaining nutrition and muscle may be the priority.
Medical assessment and optimisation. We review your symptoms, medical history and medicines, identifying issues that may need treatment or specialist input. This reflects CPOC’s emphasis on assessment, optimisation and shared decisions. With your consent, we can communicate findings to your GP or hospital team. Read CPOC’s preparation priorities.
Smoking, alcohol and wellbeing support. CPOC’s preparation advice includes stopping smoking, moderating alcohol and mental wellbeing. Where relevant, we offer education and signposting to appropriate services. Some trials include formal psychological support; our exercise and nutrition programme does not substitute for specialist psychological care.
Finding treatable barriers to preparation
Fatigue or reduced exercise tolerance may have contributors that deserve investigation. Depending on your assessment and package, selected blood tests can look at anaemia, kidney function, liver function, thyroid function and other clinically relevant concerns. Results guide individual management rather than a standard treatment for everyone.
CPOC’s anaemia guidance recommends identifying anaemia early, investigating its cause and using appropriate treatment. Iron is considered when iron deficiency is identified; intravenous iron is an option when clinically appropriate, not a routine requirement for every patient. Treatment decisions take account of the cause, timing of surgery and your wider health. Read the updated CPOC anaemia guidance.
Diabetes, blood pressure, heart or lung conditions, suspected sleep apnoea and medication concerns may also require coordination with your usual clinicians. We help identify when specialist assessment or changes to the exercise plan are needed. Your surgical and anaesthetic teams remain responsible for decisions about your operation and perioperative care.
Understanding your starting point
Assessment helps us choose activities that are appropriate for you. It may include observations, ECG, body composition and functional physiotherapy assessment. Cardiopulmonary exercise testing (CPET or CPEX) may be used when clinically suitable to assess how your heart, lungs and muscles respond to exercise and help inform training intensity.
Tests are selected according to your needs and assessment package. Testing itself is not the same as prehabilitation: the value of our programme lies in using the information to guide practical preparation, appropriate treatment and review. Explore our assessments and CPET.
When should I start?
Contact us as early as possible after surgery is planned. The PREHAB trial used four weeks, but there is no single duration suitable for every operation or patient. Your plan must fit the time available and your hospital pathway. If surgery is close, we can discuss realistic priorities rather than an intensive last-minute programme.
We review progress and adapt preparation as symptoms, treatment or surgery dates change. After your operation, return to exercise is guided by your surgical restrictions and recovery, with support to rebuild function when appropriate.
Prehabilitation in Winchester, Southampton and Hampshire
The Institute of Survival welcomes enquiries from people in Winchester, Southampton and across Hampshire who want personalised support before surgery. Our aim is to turn evidence into achievable steps: preparing your strength, fitness, nutrition and everyday function alongside your medical care.
We use evidence-based interventions and do not promote unproven therapies or guarantee surgical outcomes. The right plan reflects your health, the operation ahead and what matters most to you.
Contact The Institute of Survival to discuss preparing for surgery, or explore our programmes and joining assessments.
Research and guidance
Molenaar and colleagues, PREHAB randomised trial, JAMA Surgery, 2023.
Centre for Perioperative Care: Preoperative Assessment and Optimisation for Adult Surgery.
Centre for Perioperative Care: assessment, optimisation and shared decision making.
Centre for Perioperative Care: anaemia in the perioperative pathway, updated 2025.