Patient education: Questions to ask if you are having surgery or a procedure (The Basics)

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The following is a list of questions that everyone should ask if they are told they need surgery (that uses skin incisions) or another procedure (such as endoscopy or heart catheterization).

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. Also, doctors sometimes suggest surgery or a procedure even if there are other treatments available. Some questions that are also worth asking are:

●Are there options besides surgery or a procedure? – In some cases, surgery or a procedure is 1 of several treatment options. If you have a choice of treatments, and surgery or a procedure is just 1 option, you will have to decide what to do. Your doctor can help you make this decision. This involves thinking about:

•How much your problem bothers you

•How likely the surgery or procedure is to help

•How worried you are about the risks involved

•Whether there is someone who can help take care of you at home 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 have to miss work

●What if I don't have surgery or a procedure? – Lots of different conditions can be treated with procedures or surgery. Some of these conditions 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.

●Are there different kinds of surgery or procedures that accomplish the same goal? – Sometimes a condition can be treated in more than 1 way. Ask your doctor what options you have and what the differences between them are. Below are examples of some of the main surgery and procedure options.

•Open surgery – For open surgery, the surgeon makes a cut big enough to work directly on the parts inside your body.

•Minimally invasive surgery – For minimally invasive surgery, the surgeon makes smaller cuts and uses special tools that go inside your body. The tools are controlled from the outside with the help of a camera. The surgeon can control the tools directly, or with the help of a robot (this is called robot-assisted surgery).

•Percutaneous procedures – For percutaneous procedures, the surgeon or another doctor called an "interventionalist" gets access to a part of the body through the skin. They insert a special tool and push it to the area with the problem. One type of percutaneous procedure is called "endovascular surgery." For this, the doctor goes in through a blood vessel in the leg or arm to access another part of the blood vessel, or the heart. Special tools and devices can then be pushed through 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 1 of the natural openings in the body, such as the mouth, anus, urethra (where urine comes out), or vagina. These procedures are used 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 the risks and benefits of the surgery or procedure you might have.

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. No doctor should ever appear to 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. This information might also be available online through professional society websites for patients.

What type of anesthesia will I need and what risks does it have? — Some of the risks of surgery or procedures come from the type of anesthesia that is used. Even "minor" surgeries or procedures have risks related to anesthesia.

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 to do all the things I normally do? If not, how long will it be until I am able 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 be has a lot of experience handling people having the kind of surgery or procedure you need.

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.