Email a Friend
Print ArticleRheumatoid Arthritis Health Center
This article is from the WebMD Feature Archive
Is Your Surgeon Qualified to Perform Endoscopic Surgery?
Not every surgeon can perform endoscopic surgery. To help you learn what to look for, we turned to some top minimally invasive surgeons. What would they ask a surgeon if they were patients? Here's what they said.
-
What are the surgeon's credentials?
"You need to ask why a surgeon is qualified," says Mohamed Ali, MD, director of minimally invasive and robotic surgery at the University of California at Davis. "Is this someone who only read about the technique last week in a journal? Or someone who has been doing them every week for years?""Surgeons should be board-certified in their fields," says Mark A. Malangoni, MD, professor of surgery at Case Western Reserve University School of Medicine in Cleveland. If they are, you know that they trained at an approved school and passed the basic examinations." Find out what medical organizations the surgeon belongs to, says Malangoni. "Being a member of professional organizations shows that a surgeon is up-to-date and meeting quality standards."
-
Is the surgeon skilled with different techniques?
Not all operations go as planned. While your surgeon may intend to do an endoscopic procedure, sometimes he or she may need to shift gears in the middle and switch to open surgery. In case this happens, you need to have a surgeon who is comfortable with - and good at -- both approaches, says Steven D. Wexner, MD, chief of staff and chairman of the department of colorectal surgery at the Cleveland Clinic Florida. -
How many of the operations has the surgeon done?
How many is enough? Unfortunately, there is no magic number, says Wexner. It depends on how common the operation is. But in general, Wexner and other experts say that the number of times your surgeon has done the procedure should be in the double digits - and preferably in the hundreds.But while it's a relevant question, Mehmet Oz, MD, says that you ought to take the answer with a grain of salt. "The fact is that surgeons don't really know their total numbers," says Oz, director of the Cardiovascular Institute at the Columbia University Medical Center in New York. "It's very hard to remember. For instance, if I were asked how many minimally invasive mitral valve repairs I did, I bet I'd come up with a wrong number."
-
How often does the surgeon do these operations?
According to experts, this question is key. "Unless the operation you need is very uncommon, your surgeon should be doing them at least once a month," says Oz. "A surgeon who is doing them less than that would make me nervous." -
What are the surgeon's success rates?
Ask about your surgeon's outcomes, says Ali. "There are people who may have done an operation a thousand times, but with horrible results," he tells WebMD. Ali suggests you compare your surgeon's success rate for a particular operation with the success rates published in medical journals.
Published Oct. 27, 2005.
del.icio.us
Rheumatoid Arthritis Guide 
- Learn about Treatment for Moderate to Severe Rheumatoid Arthritis (RA)
- Is This RA Treatment Right For You?
- Some Fast Facts
Important Safety Information you should know about HUMIRA® (adalimumab).
Serious infections have happened in patients receiving HUMIRA. These infections include TB (tuberculosis) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some patients have died from these infections.
Before starting HUMIRA:
Tell your doctor if you think you have an infection, are being treated for an infection, have signs of an infection (such as a fever, cough, or flu-like symptoms), have any open sores on your body, have warm, red, or painful skin, get a lot of infections or have infections that keep coming back, have or had hepatitis B infection, take the medicine Kineret (anakinra), have TB or have been in close contact with someone who has TB, have lived in an area where TB or histoplasmosis is common, or were born in, lived in or traveled where there is more risk for getting TB. Your doctor should test you for TB before starting HUMIRA. If your doctor prescribes any medicine for the treatment of TB, you should start taking it before starting HUMIRA and take the full course of TB medicine prescribed.
Tell your doctor if you have any numbness or tingling, or have a disease that affects your nervous system such as multiple sclerosis or Guillain-Barré syndrome, have heart failure or other heart conditions, are scheduled for major surgery, are pregnant, become pregnant, plan to become pregnant or are breastfeeding. Tell your doctor if you are allergic to HUMIRA or any of its ingredients or are allergic to rubber or latex. The needle cover of the prefilled syringe and the pen contain dry natural rubber.
Also, tell your doctor if you have recently received or are scheduled for any vaccines. Except for live vaccines, patients may still receive vaccines while on HUMIRA. It is recommended that children with juvenile idiopathic arthritis be brought up to date with all immunizations prior to starting HUMIRA.
After starting HUMIRA:
Call your doctor right away if you get an infection, or any sign of an infection including a fever, feeling very tired, cough, flu-like symptoms, warm, red or painful skin or if you have any open sores on your body. HUMIRA can make you more likely to get infections or make any infection that you may have worse.
Possible side effects of HUMIRA:
Serious side effects, which sometimes lead to death, have happened in patients taking HUMIRA.
- Serious infections. These infections include TB (tuberculosis) and infections caused by viruses, fungi, or bacteria. Your doctor will examine you for TB and perform a test to see if you have TB. If your doctor feels that you are at risk for TB, you may be treated with medicine for TB before you begin treatment with HUMIRA and during treatment with HUMIRA. Even if your TB test is negative your doctor should carefully monitor you for TB infections while you are taking HUMIRA. Patients who had a negative TB skin test before receiving HUMIRA have developed active TB. Tell your doctor if you have any of the following symptoms while taking or after taking HUMIRA: cough, low-grade fever, weight loss, or loss of body fat and muscle.
- Certain types of cancer. There have been cases of certain kinds of cancer in patients taking HUMIRA or other TNF blockers. Patients with RA, especially more serious RA, may have a higher chance for getting a kind of cancer called lymphoma. Some patients receiving HUMIRA have developed types of cancer called non-melanoma skin cancer (basal cell cancer and squamous cell cancer of the skin), which are generally not life threatening if treated. Tell your doctor if you have a bump or open sore that doesn't heal.
- Allergic reactions. Signs of a serious allergic reaction include skin rash, a swollen face, or trouble breathing.
- Hepatitis B virus reactivation in patients that carry the virus in their blood. Tell your doctor if you have any of the following symptoms: feel unwell, poor appetite, fatigue, fever, rash or joint pain.
- Nervous system problems. Signs and symptoms include: numbness or tingling, problems with your vision, weakness in your arms or legs, and dizziness.
- Blood problems. Symptoms include a fever that does not go away, bruising or bleeding very easily, or looking very pale.
- New heart failure or worsening heart failure you already have. Symptoms include shortness of breath or swelling of your ankles or feet, or sudden weight gain.
- Immune reactions including a lupus-like syndrome. Symptoms include chest discomfort or pain that does not go away, shortness of breath, joint pain, or rash on your cheeks or arms that gets worse in the sun.
Call your doctor or get medical care right away if you develop any of the above symptoms. Your treatment with HUMIRA may be stopped.
Common side effects of HUMIRA are: injection site reactions (redness, rash, swelling, itching or bruising), upper respiratory infections (sinus infections), headaches, rash and nausea.
These are not all the side effects with HUMIRA. Ask your doctor or pharmacist for more information.
Information You Should Know About HUMIRA® (adalimumab).
HUMIRA is used to reduce the signs and symptoms of moderate to severe rheumatoid arthritis in adults, may prevent further damage to your bones and joints, and may help your ability to perform daily activities. HUMIRA can be used alone or with methotrexate or with certain other medicines. HUMIRA is used to reduce the signs and symptoms of moderate to severe polyarticular juvenile idiopathic arthritis in children 4 years of age and older. HUMIRA can be used alone or with methotrexate or with certain other medicines. HUMIRA is used to reduce the signs and symptoms of psoriatic arthritis in adults, may prevent further damage to your bones and joints, and may help your ability to perform daily activities. HUMIRA can be used alone or with certain other medicines. HUMIRA is used to reduce the signs and symptoms of ankylosing spondylitis in adults. HUMIRA is used to reduce the signs and symptoms of moderate to severe Crohn's disease in adults who have not responded well to conventional treatments. HUMIRA is also for these adults with moderate to severe Crohn's disease who have lost response or are unable to tolerate infliximab. HUMIRA is used to treat moderate to severe chronic (lasting a long time) plaque psoriasis in adults who are under the ongoing care of a physician, have the condition in many areas of their body and who may benefit from taking injections or pills (systemic therapy) or phototherapy (treatment using ultraviolet light alone or with pills).
HUMIRA is taken by injection.
64S-154126
Find a hospital by procedure or condition
WebMD Health Check
Living With Rheumatoid Arthritis
Many treatments are used to stave off the painful effects of RA from aspirin to drugs called ‘biologic agents.'
