How do I Pick a Robotic Surgery Program?

Robotic surgery, usually using the da Vinci robotic-surgery system, is increasingly popular with patients scheduled for cancer operations and other procedures involving gynecological, urological, thoracic or cardiac surgery. Because it is performed through a few small incisions in the body, robotic surgery has the advantage of being precise and offers faster recovery times, less scarring and better outcomes for many operations. With almost every major hospital now jumping on the robotic surgery bandwagon, how can a patient choose the best program?

Things You'll Need

• Referrals from primary care physician or specialist
• Friend or family member to accompany you and take notes
• Checklist of your concerns and desired outcomes

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Instructions

Interview three surgeons from at least two if not three different hospitals

• 1

  Get referrals from doctors you respect

  Find three to five surgeons who have performed the specific robotic-surgical procedure you need. Coronary bypass surgery, a hysterectomy, prostate surgery and a thyroid procedure all are vastly different. You will probably have referrals to a surgeon from a specialist or primary care physician. It is a good idea to ask your doctor for the "best in breed" hospital locally that specializes in the type of surgery you require. Try to get a referral to a top robotic surgeon at that hospital, or call the hospital directly. Most hospital websites will have department directors listed. Don't hesitate to call other doctors you respect for additional referrals. Because you don't know which surgeons might have availability problems, it is better to start with more choices and then narrow it down.

• 2

  Make a checklist of questions and concerns

  Set up appointments with the robotic-surgery physicians on your list. Make a checklist of your concerns and questions before the interviews. Ask a friend or family member to accompany you, and review the list with them. If you become too overwhelmed or emotional to take good notes or ask questions, your companion can help.

• 3

  Evaluate each surgeon's experience

  Determine the experience level of each surgeon. You will want to make sure that your surgeon has a medical degree and is board-certified in the type of surgery to be performed. Then ask the doctors the number of times they have performed the robotic operation you are seeking and how many years of experience they have in the field. Inquire about their track record and outcomes. Be specific about your concerns for any loss of function or side effects that might occur. Ask about average recovery times and any special situation that applies to you. In the event of cancer, ask about recurrence statistics and post-surgical treatment plans. Find out the best possible outcomes and the biggest downsides.

• 4

  Evaluate the whole surgical team

  Evaluate the whole surgical team's experience. The surgeon should work often with his or her "team" and should be able to tell you the number of times he has worked with the second or assisting surgeon, anesthesiologist and surgical nurse who will be scheduled for your operation. Having a second surgeon to assist is a good idea. In case of the unexpected, a second pair of hands is available immediately.

Narrow your choices to two surgeons and hospitals

• 5

  Eliminate the least-experienced surgeons and the newest programs from your list. Robotic surgery has a "learning curve," and a surgeon will need to perform at least 25 to 50 operations of each type just to be familiar with the robotic equipment and the pace of the operation. Although controversial, many professionals believe that 200, 300 or even more more operations are the needed experience for a surgeon before becoming proficient in the field of robotic-assisted surgery. From a risk standpoint, the shorter the procedure the less stress on the patient. Narrow your choices to two surgeons. You likely will prefer one, but it is good to have a back-up.

• 6

  Ensure that your operation will be performed at a location that has advanced clinical expertise. Robotic surgery should be performed in an accredited hospital, outpatient surgery center or cancer treatment center. Although the skill of the specific surgeon and team are paramount, you should try to select a hospital setting known for excellence in the type of surgery you are seeking or the type of after-care you will need, if applicable. Many surgeons operate at two or more hospitals. Each hospital will have its strengths. Some will have special centers and support groups with post-operative therapies just for your specific condition. This type of hospital is likely to have ongoing, state-of-the-art training for its staff.

• 7

  Make sure your top-choice surgeon can schedule your operation in the time frame desired. Operations for cancer usually are done as soon as possible. Other operations might require additional testing. If your top-choice surgeon is not available but you like your second choice equally, go with our second choice.