Is the robot right for you?

If you're facing prostate surgery, a hysterectomy, even heart bypass, you've got one more question on your list: Should I go robotic?

We asked the experts for advice on choosing the best option for you.

• Consider your comfort level with technological advancements. Do you want to be on the cutting edge, or stick with the tried-and-true? Where robotic surgery falls depends on the particular procedure.

Robotic prostate removals are fast on their way to becoming mainstream. Not so with coronary artery bypass grafts, a delicate operation that is difficult to do robotically. Only a few surgeons in the nation perform robotic bypass operations. Ask your doctor whether there's scientific evidence showing a robotic approach is better for a patient like you.

• Be honest about your medical history. Prior surgeries may disqualify you from a robotic procedure, says Dr. Karen Fish, a gynecologist who performs robotic surgeries at Advocate Lutheran General Hospital in Park Ridge. A surgeon must know the patient's anatomy while inserting the robotic instruments, the riskiest part of the operation, Fish says. Scar tissue can get in the way.

Patients with some lung disorders can't tolerate the carbon dioxide gas used to inflate the body cavity during a robotic operation.

• Get a second opinion, says Dr. Arieh Shalhav, a urologist at the University of Chicago who performs robotic prostatectomies. If your first surgeon uses the robot, get a second opinion from a doc who favors an open approach.

A traditional approach might be better for some patients. For example, Shalhav might choose an open surgery for a 50-year-old man worried about incontinence and impotency.

"If he's very adamant about saving the nerves, doing it open allows the surgeon to have a little more decision making," Shalhav said.

• As with any medical procedure, experience counts. But it has to be the right kind of experience. Skills developed in open surgery are important, but don't necessarily translate to robotic surgery, Shalhav says.

Look for a doctor who has done at least 40 robotic procedures, at which point his robotic outcomes should be at least as good as his results from open surgery. Shalhav says he'd want a surgeon with at least 200 robotic surgeries under his belt, averaging two or three a week. A surgeon who has performed 400 robotic surgeries is expert, Shalhav says.

• Ask detailed questions, including exactly what the surgeon will use the robot to do, says Dr. Valluvan Jeevanandam, chief of cardiac and thoracic surgery at the University of Chicago Medical Center.

A percentage of patients might be "converted" to open surgery during a robotic operation if problems arise. Ask what will happen in that case. Some surgeons use the robot to do part of a heart surgery -- such as the retrieval of an artery -- but the patient still has his chest opened up.

"Ask how many people get referred for robotic surgery, and how many actually get it," Jeevanandam said. "There's a lot of advertising."

• The robot doesn't have a monopoly on minimally invasive surgery. Doctors can use laparoscopes for gallbladder surgery, to remove ovarian cysts and to perform other operations. Some of these procedures are more difficult for a surgeon to perform. From a patient's perspective, there's no difference in recovery, Fish says.