When You're Considering Surgery

by Robert S. Dinsmoor

When You're Considering Surgery

The chances are good that one day you will need surgery. The surgery may be a simple procedure, keeping you in the hospital for only a short time, or it may be complex, requiring a lengthy stay. Either way, it will most likely be elective surgery — that is, surgery that is planned rather than done on an emergency basis. You will have time to research the procedure, choose a good surgeon, and get a second opinion if you need to.

Millions of Americans have surgery every year. Among the most common procedures are some related to arthritis, such as a knee or hip replacement, removal of a ruptured vertebral disk, or a spinal fusion (fusion of two or more vertebrae of the spine). Other common operations include appendectomy (removal of the appendix), hysterectomy (removal of the uterus and sometimes the cervix), cataract surgery, prostatectomy (removal of part or all of the prostate), cholecystectomy (removal of the gallbladder), and hernia repair.

Getting the right surgeon

Often it is a person’s primary care physician who first recommends surgery. If so, the physician may be able to recommend a specific surgeon who can perform the procedure. You can also ask friends, family members, and coworkers for the names of surgeons they have used for similar procedures. You will also want to check with your insurance company or Medicare for any restrictions as to which surgeon and which hospital you are able to use.

Make sure any surgeon you are considering is qualified and is experienced in doing the procedure you’re going to have. Find out whether the surgeon is “board certified” in surgery, meaning that he or she has had special training and has passed exams administered by a national board of surgeons. The surgeon’s certification should be from a surgical board that is approved by the American Board of Medical Specialties (ABMS). You may be able to find a reference book titled The Official ABMS Directory of Board Certified Medical Specialties at your local public library or through state and county medical associations. The book contains brief information about each surgeon’s medical education and training. You can also find out a surgeon’s board certification status by visiting the ABMS Website or by calling (866) ASK-ABMS (275-2267).

If the surgeon has the letters “FACS” after his or her name, he or she is a Fellow of the American College of Surgeons and has passed another review of surgical skills by other surgeons. For information about how to find Fellows of the American College of Surgeons in your area, see "For More Information."

It is safest to use a surgeon who has had a lot of experience in the particular surgical procedure you’re considering because there is a learning curve to these procedures. Generally speaking, the more procedures a surgeon has performed, the more skillful he or she becomes at carrying out that procedure. It is completely appropriate to ask a surgeon about his or her recent track record of successes and complications with this operation. If this makes you uncomfortable, you can always discuss the surgeon’s qualifications with your primary care doctor.

However you go about finding a surgeon, you need to be clear on a few things before deciding whether to have surgery. Here are the most important considerations.

Why and how

First of all, if your doctor is recommending surgery, it’s important to understand why. Is it to improve quality of life? (Examples are joint replacements and cataract surgery.) Is it to uncover the underlying cause of a problem? Or is it to prolong your life? (An example is angioplasty.) Make sure your surgeon fully explains the reason for the procedure, how it will fix the problem, and what the consequences are of not having the surgery.

You also want to know, in detail, how the surgery is done. What are the steps involved? In some cases, the surgeon may be able to draw a diagram of what is going to be done.

You should also know whether there is more than one way to do the operation. For example, a number of procedures can now be done laparoscopically. In laparoscopic surgery, the surgeon makes several small incisions instead of one large one and inserts a laparoscope through one of the incisions and tiny surgical tools through the others. The laparoscope — a tiny tube with a camera on its end — sends images to a video monitor, and the surgeon uses those images to guide him or her through the surgery. Or to use another example, knee replacements may sometimes be done using a smaller-than-usual incision and specially sized surgical instruments, and/or the surgeon may use new techniques that involve less cutting of tendons. These minimally invasive surgical techniques can mean shorter recovery times, but they aren’t always appropriate. If there is more than one way to do the surgery you’re contemplating, find out why your surgeon has chosen one procedure over another.

Last Reviewed on April 20, 2011

Robert Dinsmoor is a medical writer and editor based in Massachusetts.

Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.

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