Based on my experience, you would likely have to fly out for the initial consultation, then fly back again for surgery. For MGH, at least, the soonest they where able to book my surgery was for 5.5 weeks out from when it was deemed necissary, and I doubt that they would be willing to commit the resources required to prepare for surgery for a situation that wasn't certain.
This is how the process went for me:
1. I received a referral from local neurologist.
2. I was contacted my Dr. Donahue's secretary/assistant, Pat. She walked me through making sure all my records and imaging results would be mailed to Dr. Donahue's office in the weeks prior to my consultation. In addition, they will mail you a 12-15 page questionnaire to complete and bring with you to your first appointment.
3. Consultation appointment. In my case, Dr. Donahue described my problem as it appeared to him. He stepped me through his interpretation of my imaging results, then led me through a series of positions/holds/strength tests. He told me that he only recommends surgery for 1/5 of the TOS cases, and doesn't rush to make any decisions. In my case, however, he recommended surgery for my left arm (which is a much more severe case than my right arm).
4. Within a week, this office staff contacted me with the details of the time and location of my operation. In my case the soonest they where able to secure the operating room and fit within Dr. Donahue's schedule was 2/5- 5.5 weeks from the date it was set.
5. It addition to the surgery itself, I have also committed to an appointment a week prior (1/30) for pre-operative preparations. I don't really know what this will entail, but if anyone is interested I will provide the details after I'm through it.
I hope this helps!