**5.2 Preoperative procedure principles**

There is evidence abdominal shave if done should be performed in the operating room just before applying the antiseptic preparation and not a night before. Prolonged shave to operating time increases the bacterial count on the abdomen. The abdomen is scrubbed with alcohol containing solution or nonorganic iodide solution.

Nonparticulate antacid should be given orally before transferring patient to operating table. In some instances, long acting antacid could be given a night before like Ranitidine 150 mg orally. Metoclopramide is given to increase the tone of lower oesophageal sphincter, preferably after oxygenation [6, 7].

Patient should be placed in the 15 degree left lateral tilt position to minimise uterine compression of inferior vena cava [8]. Urinary catheter should be placed to allow the bladder to drain during the operation keeping the operative field clear.

The principle should be to have adequate exposure but not excessive. Gentle handling of tissues with attention to haemostasis.
