Patients are often given the impression that all keyhole surgery is the same. It is not. Complication rates, conversion-to-open rates, fertility preservation and recurrence all vary considerably between surgeons performing the same named operation. The reassuring part is that the differences are measurable, and any good surgeon will happily discuss their own numbers.
Volume and specificity
Ask how many of your exact procedure the surgeon performs each year, not how many operations in total. A surgeon doing forty laparoscopic myomectomies annually is in a different category from one doing four, even if both are highly experienced generally.
Ask also what proportion of their practice is minimally invasive. Surgeons who operate laparoscopically as their default are usually the ones who can keep a difficult case keyhole rather than converting.
A surgeon who readily shares their conversion and complication rates is telling you something important before they answer.
Honest numbers
Conversion rate to open surgery, complication rate, readmission rate and — for fibroid and endometriosis surgery — recurrence rate over five years are all fair questions. A surgeon who has never had a complication is either very new or not counting.
What you want is a specialist who quotes their figures readily, explains how they compare to published benchmarks, and describes what they do when things go wrong.
Fertility and goals alignment
If future pregnancy matters to you, say so at the first appointment and ask directly how the plan protects it: uterine reconstruction technique, ovarian tissue-sparing approach, adhesion prevention. The answers should be specific rather than reassuring generalities.
The team and the aftercare
Ask who will actually perform the operation, who assists, which anaesthetist and which hospital. Ask what follow-up is included, who you call at 2am in the first week, and whether the surgeon reviews you personally afterwards. Continuity is a quality marker, not a luxury.
Nine questions worth asking
- How many of this exact operation do you perform each year?
- What is your conversion rate to open surgery?
- What are your complication and readmission rates?
- How does the plan protect my fertility?
- Who else will be in theatre, and who operates?
- What follow-up is included in the quoted cost?
- Who do I contact out of hours in the first week?
- What is the expected recurrence rate for my condition?
- What would make you convert to open surgery?
Common questions
Is it rude to ask a surgeon about their complication rate?
Not at all. It is a routine and reasonable question, and experienced surgeons expect it. How readily it is answered is itself informative.
Should I get a second opinion?
For any major or irreversible operation, a second opinion is sensible and standard practice. A confident surgeon will support you in seeking one.
Book a consultation with Prof. Parkar
A private, unhurried appointment to review your history and design a plan that fits your life.
