Texas Governor Greg Abbott recently eased restrictions on elective surgeries implemented to help curb the spread of COVID-19. Ted Klein, M.D., MPH, urologist at Texas Urology Specialists–Medical City Dallas, discusses surgical care amid the COVID-19 pandemic, common patient concerns about surgery, and recent surgical advancements.
How has the COVID-19 pandemic changed your approach to surgery?
While restrictions on elective surgeries were in place, we were still able to treat patients in need of immediate surgery. For example, some patients with high-risk bladder cancer or kidney cancer were still able to have surgery. Now that Texas is cleared to resume elective procedures, our teams at Texas Urology Specialists are pre-screening patients for symptoms of COVID-19 over the phone and performing a COVID-19 test on each surgical patient two days prior to their scheduled procedure. If a patient tests positive for COVID-19, we discuss the urgency of the patient’s medical situation and absolute need for surgery to determine whether it can wait.
Have patients expressed concerns about having surgery amid the COVID-19 pandemic?
Since we don’t expect COVID-19 concerns to pass in the coming weeks, or even months, we have discussions with each patient about their risk and their comfort level with proceeding with surgery based on the progression of their disease. Some patients have opted to wait until June or July. Other patients worry about a second surge of the virus should they delay their surgery.
Our reliance on robotic surgery at Texas Urology Specialists provides comfort to patients, especially those who worry about spending recovery time in the hospital. Robotic surgery is minimally invasive and reduces recovery time. Throughout the COVID-19 pandemic, we have continued to perform in-office surgical procedures, which are also minimally invasive.
The most important step patients can take to feel comfortable with their surgery is to find a physician and care team they can trust.
What role does telemedicine play in your care for patients?
Through our expanded use of telemedicine, we continue to safety follow the progress of patients requiring consultations or follow-ups. At Texas Urology Specialists, we also use telemedicine to review labs and imaging with patients. Patients feel relief in knowing that telemedicine appointments reduces the risk of exposure for them and our staff. Plus, it’s helpful for patients who may not have childcare right now.
How has surgical care improved over the past several years?
One of the biggest advancements has been the progression of laparoscopic surgery to robotic-assisted laparoscopic surgery. It’s allowed us to treat more patients and reduce the length of hospital stays. Complex surgeries can be done more efficiently with smaller incisions, resulting in a less painful recovery. Surgeons are better able to clearly visualize the detail of organs, like the kidney, and the position of the tumor.
Advancements in genetic testing have also improved the way we serve patients. Genetic testing helps us better asses risk to more comfortably determine who requires surgery and who can be kept on active surveillance based on the potential aggressiveness of the disease.
What advice do you have for patients?
The most important step patients can take to feel comfortable with their surgery is to find a physician and care team they can trust. There’s benefit to having a trusted team who frequently works together – day in and day out – including the same nurses, anesthesiologists, and assistants. The efficiency and workflow of surgery is incredibly important. Our goal at Texas Urology Specialists is to work cooperatively to achieve the best outcome.