Preoperative medical consultation may decrease the risk of surgery in multimorbid patients by an exact preoperative evaluation and pretreatment of all cardiopulmonary, hematologic and metabolic diseases. Excellent teamwork among internists, anaesthesiologists and surgeons is necessary. The increase in specialization in surgical and conservative medicine has produced a variety of alternative diagnostic and therapeutic procedures and so there should be a consensus as to which diagnostic and therapeutic procedure is best.