Most people are candidates for da Vinci® Surgery, but it may not be right for everybody. Only you and your doctor can decide whether da Vinci Surgery is right for you. Before making your decision, you should make sure you are aware of all the options available to you, as well as your physician’s experience as a da Vinci surgeon.


To determine if you are a candidate for da Vinci Surgery, and to ensure you get the information you need from a consultation with your physician, we have put together a brief questionnaire that you can take into your doctor’s appointment with you.


If you'd like to print this page first, just click here. You can also download this questionnaire as a pdf.


My symptoms or conditions are:
Pelvic Pain
Abnormal Bleeding
Uterine Fibroids
Falling Uterus or Bladder (Prolapse)
Other/Not Sure


Please Check All That Apply:
I would like to avoid a large incision and scar.
It is important that I am able to return to my normal activities (e.g., driving) as soon as possible after surgery.
I would like to minimize the length of time I am in the hospital to just one night, if possible.
I would like to minimize my blood loss and need for blood transfusion(s) during surgery.
I would like to limit the amount/duration of pain medications I take after surgery.
I would like to minimize my risk of infection after the surgery.


For more information please contact us.