Questions to Ask Your Doctor Before Elective Surgery During COVID-19
With the Delta variant, a nearly twice as contagious variant of the COVID-19 virus surging in the United States, some people may still be concerned about potential health risks from having elective surgery. The Center for Innovative GYN Care, having recognized since the start of the pandemic that pain and other GYN symptoms can’t wait, has been committed to providing expert minimally invasive treatment in the safest environment possible.
If you are discussing having surgery with your OBGYN for fibroids, endometriosis, pelvic pain or any other condition, be sure to ask the following questions to make sure your procedure will be performed under optimal conditions. Seek a second opinion if you have any doubts about the environment.
1) Where Will You Perform My Surgery?
Physicians either have admitting privileges at one or more hospitals, where outpatient elective surgeries are most often performed, or they operate at an independent ambulatory surgery center (ASC), which is subject to the same health and safety regulations as hospitals. The Center for Innovative GYN Care, treats patients at freestanding, fully licensed and certified ASCs.
Ambulatory surgery centers offer patients multiple advantages. Because ASCs are not part of a hospital system, they are more efficient and offer patients the option to schedule surgeries sooner. In addition, the smaller, easier-to-control footprint and limited clientele of ASCs lessen the risk of exposure to COVID-19 compared to large hospitals that treat patients with viral infections.
2) Will I Have to Stay Overnight in the Hospital?
This is an important consideration during a pandemic: The less time spent in a hospital, the better.
Length of stay generally depends on the approach and incisions the surgeon uses.
- Open surgery, the method preferred by many OBGYNs who do not perform a high number of complex GYN surgeries per year, could require up to a three-night hospital stay due to its large incision (10 to 15 cm) in the abdomen.
- Robotic-assisted surgery, in which as many as five to six (or more) ½-inch abdominal incisions are made, can involve a one- to two-night stay.
- Standard laparoscopic surgery uses four ¼-inch abdominal incisions. Patients may go home the same day or require an overnight stay.
- GYN surgeries with CIGC’s specialists aren’t performed in a hospital — they take place in an ambulatory surgery center, and patients go home the same day. What makes this possible are CIGC’s two advanced laparoscopic methods — DualPortGYN® and LAAM®. These surgical options use retroperitoneal techniques to control blood loss, avoid injury to surrounding structures and require only two small incisions. Both surgeries are done in a fraction of the time robotic procedures take. Outcomes are exceptional, including the lowest complication rates compared to other surgical methods.
3) What measures is the facility taking to protect patients and staff from COVID-19?
Ambulatory surgery centers follow recommendations from the Centers for Disease Control, state health departments and various professional organizations that govern health care facilities.
In addition to requiring personal protective equipment (PPE) for health care personnel and screening these employees for symptoms daily, when indicated by state law, precautions include, COVID-19 testing; requiring masks and social distancing; cleaning and sterilizing patient rooms and equipment between appointments; limiting the number of people allowed in waiting rooms and asking visitors or people accompanying patients to wait outside; and asking employees to stay home if they have symptoms of a cold or fever. If a region’s COVID-19 case volume spikes, additional safety measures may be implemented.
4) Can I delay my surgery until the pandemic is over?
Delaying care by not seeing a doctor or canceling a scheduled surgery has risks.
One potential consequence of putting off treatment is progression of the disease or condition, which can lead to long-term problems. For example, you may require a blood transfusion prior to surgery and, ultimately, the need for a more complex surgical procedure. This complexity can then lead to increased complications, or the need for a more invasive procedure with more pain and a much longer recovery time.
In the case of precancerous or early-stage cancer that is not treated promptly, disease progression can lead to the need for additional therapy after surgery —radiation or chemotherapy, for example — and possibly a lower chance for a complete recovery.
Speak with your doctor about potential ramifications of delaying care compared to having the procedure. If you do decide to postpone, your doctor may suggest an interim measure such as medical therapy or a telemedicine appointment to manage your condition temporarily.
5) How can a telemedicine session benefit me if I must wait to have surgery?
CIGC offers telemedicine appointments using a secure, HIPAA-compliant software. Examples of what our specialists can do for you online include prescribing or adjusting medication; remotely monitoring home health data such as blood pressure readings; and discussing your symptoms to gauge the status of your condition.
6) How soon can you perform my procedure?
If you live in an area that saw many COVID-19 hospitalizations earlier in the pandemic, your local health care facilities may have had to close to all but emergency cases. Once hospitals could open again, there was a backlog of elective surgeries that made it difficult for physicians to get their patients scheduled. CIGC surgeons have greater flexibility in scheduling their procedures as all surgeries are performed in an ASC.
It’s important to note that as COVID-19 infection rates climb dramatically once again, hospitals may need to limit elective surgical procedures due to resources being directed to the care of patients with the virus. The use of ASCs can prevent the need to delay treatment.
7) What should I do if my hospital surgery is canceled due to COVID-19?
Have your procedure with a surgeon who is based at an ASC. Your procedure likely will be scheduled far sooner. One hallmark of CIGC is that patients do not face long waits to have their surgeries with a specialist.
Surgeons who are well-versed in performing procedures — even advanced surgeries — effectively and safely in the hospital outpatient setting can begin working with an ASC to offer this option to their patients. This will allow more patients to access quality care sooner and avoid potential exposure to the virus in hospitals. As surgeons, we have an obligation to our patients to avoid delays in care that could lead to either progression of the disease or to patients waiting until they have severe pain and life-threatening bleeding, followed by an ER visit for evaluation and possible transfusion.
If you are unable to have your surgery with a physician who uses an ASC, ask your physician about telehealth sessions and any medical therapy that can help alleviate your symptoms until your procedure is rescheduled.