Questions to ask before having surgery.

In the US, millions of people have surgical procedures done every year. Some of these are simple, straightforward, outpatient procedures while others more complex and some are emergent and unplanned.

As a healthcare consumer, it is important to be well informed about the procedure you are going to have. This is especially true if it is elective surgery rather than an emergency surgery.

All surgeries, even simple ones, have inherent risks and benefits. It's important to understand them before deciding whether the procedure is appropriate for you.

In order to be a well informed healthcare consumer, it is important to ask questions.

More importantly, you need to ask the right questions.

The more involved you are in your care, the more informed you are about the procedure you are having, the better the outcome,

Below, I will give you a surgeon's perspective on what questions need to be asked before having surgery.

Why do I need surgery?

There are many reasons a person may need surgery, but the most important reason is the underlying diagnosis.

For example, someone might have had an accident that damaged his/her spine and now needs spinal fusion surgery; or perhaps that same person knee injury skiing and will need anterior cruciate ligament (ACL) reconstruction; or maybe he/she cancer that needs an operation to treat or cure.

Once you know and understand the diagnosis you can make an informed decision about how to proceed.

The next important question is, do you really need surgery?

What are my non surgical treatment options?

You should always ask about alternative treatments. If you have a medical condition that could be helped with medication or physical therapy, it's important to know what the success rate is for other options first.

You should also be aware of any costs involved in the procedure and ensure it is covered by your insurance before deciding whether you want to proceed with surgery.

It is perfectly ok to ask how much the procedure will cost, as well as if the surgeon performs this type of surgery, and if so, how often and what are the outcomes.

It's also important to consider all possible risks associated with having surgery so that you can make an informed decision about whether or not it is right for your situation.

Not every situation requires surgery and there may be non surgical treatments.

Your physician can and should explain the benefits and risks of these choices so that you can make an informed decision about whether or not surgery is necessary.

Sometimes "watchful waiting" is indicated, and at times waiting could potentially put your health at risk.

What are the benefits of this procedure?

You want to know what you'll get out of having surgery.

You might be thinking, "What's in it for me?" or "How long will I have to stay in the hospital?"

The answers to these questions can help you decide whether or not surgery is right for you.

Obviously if the need for surgery is emergent or it is considered a life saving operation, the luxury of taking the time to ask these questions is lost.

What are the risks/complications of the procedure?

Any surgical procedure has some risks. It is important to weigh the benefits against the risks before surgery.

Ask your surgeon about the possible complications, such as infection, bleeding, injury to adjacent organs and possible side effects that could follow the procedure.

If a complication does occur, what resources are available?

For example, if a general surgeon or urologist is doing your surgery, what happens if there is a vascular injury (injury to a major blood vessel)?

Is there a vascular surgeon available at that hospital?

What if you need to be in the intensive care unit after surgery?

Does that hospital have an ICU and if so who will be taking care of you there.

You want to make sure there are board certified critical care physicians that will be available to provide critical care if needed.

Could I have more than one procedure at the same time?

You may be wondering if you can have more than one procedure done at the same time. This is a common question, and there are benefits to having multiple procedures performed in quick succession:

• It allows you to get more procedures done during one visit. One of the biggest benefits of getting multiple procedures done at once is that it can shave months off your recovery time, which means less time spent recovering before being able to return back home with friends and family!

It is important to understand that it is not always in your best interest to have multiple procedures at the same time and a frank discussion with your surgeon can help with this decision making process.

Who is performing your surgery?

The first thing you want to know is if your surgeon is board certified and in good standing with the state medical board. This information is easily available via a google search.

It is perfectly acceptable to ask your surgeon his or her experience with the procedure, how many cases they do per week, month or year and what complications they have had or seen with this procedure.

You also want to know if there will be physicians in training (surgical residents) that will be involved in your surgery. Some hospitals use surgical assistants or Physician Assistants/Nurse Practitioner in the operating room. You want to know who is going to be involved in your surgery.

What surgery are you having?

You need to know what procedure you are having done. Ask the name of the procedure, the steps involved and ask for examples. You also want to know if there are different approaches, such as minimally invasive versus open surgery.

What type of anesthesia does this procedure require?

Depending on what procedure you are having done, you may have local, regional, or general anesthesia. General anesthesia is where you are completely asleep and placed on a ventilator (breathing machine) for the duration of the case.

Just as you checked the surgeon's credentials, you want to make sure that there is a board certified anesthesiologist that is in good standing with the state medical board who will be taking care of you. Many hospitals now have Certified Nurse Anesthetists who work with the board certified anesthesiologist to provide care while you are having surgery.

I would not recommend having surgery where no anesthesiologist (a board certified physician) is immediately available.

Where is the surgery being performed?

There are big academic centers, community hospitals and a hybrid of the two. Some surgeries are performed at surgery centers.

There are advantages and disadvantages to all of them.

It is important to note that you can get great care at any of these facilities.

Obviously, rare and complicated cases are better served at larger academic centers as they have more resources dedicated to these things.

So if it is not a rare procedure or a particularly difficult or rare operation, where you choose to have surgery is ultimately a personal choice.

What is the expected post surgery course?

You want to know what recovery after surgery will be like.

Do you need to stay in the hospital?

If so, how many days?

Is it outpatient?

If so what restrictions as far as diet, activity and wound care do you have at home and when is the post surgery follow up?

You want to know how long it takes for a full recovery and when you can resume work and your regular daily activities.

After surgery is completed and you are home, you want to know who is available if you have questions and concerns and how do you contact them.

If you are unhappy with the answers to any of the above, GET A SECOND OPINION!

Having surgery is a difficult and stressful decision. You want to make sure you have a good understanding of what you are getting into. The best way to ensure this is communicating your questions and concerns with your surgeon and getting answers.

It may be worthwhile to write down your questions so you don’t forget to ask them.

The more involved you are in your care, the more informed you are about the procedure you are having, the better the outcome.

It is important to partner with your medical team to make an informed decision about which operation is best for you.

Asking these questions will help you make a well informed decision regarding surgery.