Laparoscopic Surgery Pre-Op Checklist
Patient Information
Patient Name:
MRN / ID:
Date of Birth:
Procedure:
Consent signed:
Preoperative Preparation
Fasting status confirmed
Pre-op labs reviewed
Allergies checked
Blood group noted
Imaging available (if needed)
Special equipment prepared
Antibiotics ordered/administered
VTE prophylaxis considered
Surgical Site & Team
Surgical site marked
Identification band in place
Surgical team brief completed
Instrument & device check
Patient position checked
Other
Bladder emptied/catheterised
Consent reviewed with patient
Pain management plan reviewed
Family informed
Notes: