Having Surgery

The following is a list of questions that everyone should ask if they are told they need surgery or a procedure.

Why do I need surgery or a procedure?

It sounds like a silly question, but people often don’t know why their doctor has recommended surgery or a procedure. More important, doctors sometimes offer surgery or a procedure to people who might benefit from them but who could instead be treated in other ways.

Are there options besides surgery or a procedure?

In some cases, surgery or a procedure is one of several treatment options. If you have a choice of treatments, and surgery or a procedure is just one option, you will have to decide (with input from your doctor) what to do. People decide whether to have surgery or a procedure based on:

• How much your problem bothers you
• How likely the surgery or procedure is to help
• How worried are you about the risks involved
• Whether you have someone at home who can help take care of you afterwards
• How long the recovery period might be
• Whether the surgery or procedure will relieve pain you currently have
• How much pain the surgery or procedure might cause
• Whether you would be able to miss work

What if I don’t have surgery or a procedure?

Some conditions that are treated with procedures or surgery get worse without treatment; some get better; and some stay the same. If the surgery or procedure is not absolutely necessary and your symptoms don’t bother you too much, you might decide to try other treatments.

Is there more than one surgery or procedure that accomplishes the same goal?

Sometimes a condition can be treated in more than one way. Ask your doctor what options you have and what the differences are between them. Below are examples of some of the main surgery and procedure options.

• Open surgery – For open surgery, the surgeon makes a cut big enough so that he or she can work directly on the parts of your body.
• Minimally invasive surgery – For minimally invasive surgery, the surgeon makes smaller cuts and uses special tools that go inside your body and can be controlled from the outside.
• Percutaneous procedures – For percutaneous procedures, the surgeon or another doctor called an interventionalist gets access to a part of the body through the skin. He or she inserts a special tool and advances them to the area with the problem. One special type of percutaneous procedure is an endovascular procedure where the doctor gets access to the heart or a blood vessel by accessing a blood vessel in the leg or arm through the skin. Special tools are advanced within the blood vessel to the area with the problem.
• Endoscopic procedures – For endoscopic procedures, the doctor uses a thin tube with a tiny camera on the end. The tube goes into the natural openings in the body to look at or treat conditions of the stomach or intestines (gastrointestinal endoscopy), bladder (cystoscopy), or uterus (hysteroscopy).

What are the benefits and risks of surgery or a procedure?

Every surgery or procedure, no matter how “minor,” carries risks. Make sure you understand what you stand to gain from the surgery or procedure and what you stand to lose.

Here are some related questions to ask:

• What are the chances that I will benefit and how long is the benefit likely to last?
• What are the most common risks, and how long do their effects last?
• What are the most serious risks, even if they are not very common?

What if I want a second opinion?

Do not be afraid to ask for a second opinion, if you would like one. No doctor should ever be worried or bothered if you want a second opinion. In fact, your doctor should be willing to help you find the best surgeon or interventionalist to suit your needs. You can also get the names of other doctors who perform the surgery or procedure from your primary care doctor or from people you know who have had a similar surgery or procedure.

What type of anaesthesia will I need and what risks does it have?

Some of the risks of surgery or procedures come from the type of anaesthesia that is used. Even “minor” surgeries or procedures have risks related to anaesthesia.

What will my recovery be like?

People do not always know what to expect in the recovery period after surgery or a procedure. It’s very important to find out (ahead of time) the answers to these questions:

• How much pain can I expect in the days and weeks afterward?
• How will my pain be treated or managed?
• How long will I be in the hospital?
• Will I need help when I return home?
• Will I need to have someone drive me home?
• After surgery or the procedure, will I be able drive, work, go up and down stairs, and do all the things I normally do? If not, how long will I be unable to do these things?
• When will I be able to return to work?

How much experience does my surgeon or interventionalist have?

Ask your surgeon or interventionalist, “How many of these surgeries or procedures have you done in the last year?” Find out, too, if the hospital where you will have surgery or the procedure has a lot of experience handling people having the kind of surgery or procedure you need. You want a doctor and hospital with a lot of experience.

Before you have your surgery or procedure, ask if there are treatment centers that specialize in the type of surgery or procedure you need. You might decide to get treated at a specialty center, or you might not. But knowing how your options compare will help you make the decision that’s right for you.

For some types of surgeries or procedures, it’s best to go to a place that specializes in the type of surgery or procedure you need. For example, weight loss surgery is best done at a “center of excellence” that is dedicated to this type of surgery. That’s because people having weight loss surgery often need to be seen by a lot of different healthcare providers with a special interest in obesity. Plus, people who need weight loss surgery often have special needs because of their size.

How much will surgery or the procedure cost?

Even with insurance coverage, people often have to pay some costs themselves when they have surgery or a procedure. It’s a good idea to find out ahead of time what you might have to pay. For that information, call your insurance company directly. When you speak with them, ask if they have to “pre-approve” your surgery or procedure. If cost is a concern for you, ask your insurance provider and your doctor whether there are less expensive treatment options that could help you.