Upper abdominal surgery is the most frequent major surgical procedure performed in developed countries. A postoperative pulmonary complication (PPC) is the most common serious complication after this type of surgery; the reported incidence is between 10% and 50% of patients. 

A PPC is strongly associated with increased mortality, morbidity, and healthcare costs. Pulmonary complications (including pneumonia and severe atelectasis) are caused by postoperative pathophysiological reductions in lung volumes, respiratory muscle function, mucociliary clearance, and pain inhibition of respiratory muscles.

Education and breathing exercise training are associated with a 75% relative risk reduction, but advances in minimally invasive surgery, differing levels of experience of therapists and timing of education have never been evaluated.