Fellowship trained minimally invasive GYN surgeons are available more now than ever before. These specialists perform conventional laparoscopic or DualPortGYN procedures, helping patients avoid more invasive open and robotic procedures performed by OB/GYNs.
WELL INFORMED PATIENTS
With the right tools, women can ask the right questions. Unless the answers to those questions meet a minimum threshold, patients should seek out a specialist for a second opinion. Ultimately, women get the best surgical results with the most minimally invasive procedures.
The specialist has made a commitment to surgery, and performs a higher volume of cases, more difficult cases, and uses techniques and procedures learned in their training to complete the most complex surgeries with lower complication rates.
These specialists have completed additional training either in minimally invasive GYN surgery, or in Oncology, in order to learn these techniques and procedures.
Surgery is the only medicine “practiced” by these surgeons. An orthopedic surgeon, for example, concentrates only on orthopedic surgery. The cardiac surgeon specializes in surgery of the heart and its vessels, and the cancer surgeon specializes in removal of cancerous tumors. In contrast, the OB/GYN does not concentrate mainly on surgery, but on Obstetrics.
As a consumer, be discriminating and analytical in your choice of surgeon.
Always “shop around” and get a second opinion when considering GYN surgery.
Many patients have good relationships with their OB/GYN. We understand this, and in many cases, CIGC specialists actually will help your OB/GYN perform the surgery so that your doctor can remain involved in your surgical care.
Remember that YOU are undergoing the surgical procedure. There are far better options than open surgery, robotic surgery, and standard laparoscopic surgery for almost all GYN problems. See a well qualified and well-trained minimally invasive GYN surgical specialist who is board-certified and fellowship-trained.
Part of the GYN specialist advantage is objective information from a well-qualified source. Patients who receive multiple second opinions for a surgical procedure with no prior physician-patient relationship, have a better chance to learn about all their options for better surgical care.
Good, caring physicians, like your OB/GYN, will completely understand your decision to go with a specialist, and should fully support you so that you get the best surgery possible.
THE GYN SPECIALIST ADVANTAGE: FELLOWSHIP-TRAINED LAPAROSCOPIC SURGEONS ARE THE BETTER OPTION
Fellowship-trained laparoscopic surgeons ONLY perform surgery (more than 400 cases per year), not obstetrics, and are experts at minimally invasive GYN surgery.
As a patient, it is important to find out which surgeon has specialty training. Finding that surgeon will make all the difference in your recovery, pain levels, and your return to being normal again as soon as is possible.
OB/GYN PRACTICE FOCUS
The majority of time and income for an OB/GYN practice is obstetrics. GYN surgery is a minor component (24 percent) of what the OB/GYN does. Consider the following information provided by the American Congress of Obstetrics and Gynecology (ACOG) in a 2008 survey of over 55,000 OB/GYNs in the US:
OB/GYN procedures performed annually:
Deliveries – 145
Hysterectomy – 27
This information is directly from an OB/GYN physician, and clearly shows that their practice focus is Obstetrics, not gynecologic surgery.
YOUR OB/GYN RELATIONSHIP
It is always OK to seek a surgical specialist and continue to be cared for by your regular OB/GYN. There is no other specialty comparable to that of Obstetrics and Gynecology. The OB/GYN is an obstetrician, a primary care physician, an office gynecologist, and a part-time fertility specialist, oncologist, and surgeon.
There is no reason to terminate your long term and trusted relationship with you OB/GYN. If your OB is truly concerned about providing you with the best possible care, they will understand your decision, and will continue to provide routine GYN care for you after surgery.
FACTS ABOUT MORE INVASIVE GYN PROCEDURES, ACOG 2008 SURVEY
Information from the ACOG 2008 survey in the section on OB/GYN Practice Focus:
Sixty percent of hysterectomies in the United States are still performed open, causing severe pain, higher complication rates, and longer recovery times.
These open procedures are not necessary, and are being performed by generalists that do not have the training and skills necessary to perform the surgery laparoscopically.
Patients are not being referred to specialists for better surgical care.
Robotic procedures are now being used in place of conventional laparoscopy as an alternative.
These procedures are not safer. Beware of the “marketing of medicine.”
They have more incisions, more scars, longer surgeries/recoveries, and are more expensive than conventional approaches.
A doctor who is not a minimally invasive surgical specialist may recommend a robotic or open procedure due to their lack of advanced training.
Robotic and open procedures have not shown to be beneficial for clinical outcomes and result in a longer and painful recovery.
OB/GYNs have limited experience and training in advanced laparoscopy, with the majority of their time and income invested in obstetrics.
Open and robotic approaches may be advocated since it is easier to learn, and is immediately available for the patient.
Better options of conventional laparoscopy, vaginal procedures, or DualPortGYN options may not be discussed since the OB/GYN has little training or expertise in these procedures.
Non-disclosure of better options or non-referral of the patient to a laparoscopic specialist is common, but creates moral and ethical dilemmas within the patient/doctor relationship.
Lack of access to advanced laparoscopic procedures may potentially increase pain, recovery, complication rates and cost to the patient.
Patients need to be their own advocates when it comes to surgical care and their OB/GYN.
In many cases, the surgical specialist can be present at the surgery to optimize the surgical result.
In most cases, surgical specialists will encourage patients to seek out the general care of their OB/GYN after a successful procedure has been completed.