Surgical decision making includes the objective and quantitative estimation of the patient's risk for each individual case in his given situation. For classification of risk checklists should be established to serve as basis of the decision on indication. Intraoperatively the risk should be related to the extent of operation (extension, limitation, two stages). In the postoperative period complications can occur on the basis of general and local risks, who might also newly develop. Perioperative morbidity and mortality are valuable parameters for evaluation of risk and of indication as well as the operative procedure itself.