avg. length of a the common gen. surgeries?

[haydo]

14 hour heart, liver, transplant

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[45408]

Longest I've seen here was a 14 hour fem-distal bypass with vein, but I wasn't in on that at all. Longest I've been continually scrubbed in is around 9 hours as a med student on a gyn case. Longest case I've helped on as a resident was close to 9 hours, but I had a break.

 

[inc]

Longest I've seen here was a 14 hour fem-distal bypass with vein, but I wasn't in on that at all. Longest I've been continually scrubbed in is around 9 hours as a med student on a gyn case. Longest case I've helped on as a resident was close to 9 hours, but I had a break.

14 hours for a fem-distal?

 

[Guile]

Not one, but two, >3 year hiatuses. Holy zombie thread, Batman.

 

[ZagDoc]

I think ENT may have the widest range.

Shortest case I've been involved with: 5 seconds (literally) for lysis of tongue tie
Longest case: 35 hours for 10 cm CPA meningioma resection (most of that was neurosurg however)
Longest case done entirely by ENT: 25 hours (huge floor of mouth cancer resection, B neck dissection, fibula + radial forearm free flaps)

Agree. My personal times:
Shortest case: 37 second tonsillectomy (by the attending's stopwatch. patient had deeply cryptic tonsils that were barely hanging on along the capsule)
Longest case: 19 hours (also a FOM SCC with forearm and fibula)

 

[Black Surgeon]

One of our CT guys did a 12 hour redo-redo CABG X2 (mostly due to massive scar tissue). Did the first 8 hours on day one, left the chest open (but protected) and came back the next morning to finish up. The patient made it through the surgery just fine, and had no post op infection or any other complication. I must however add that leaving the chest open for another day is definitely not common practice around these parts, haven't seen it done since, and I'm not sure what compelled him to do so.

Now before you guys start bashing, allow me to add that this guy is known to be extremely scrupulous and very methodical in the OR, and actually has some of the best numbers in our state year after year. Last year alone he posted numbers like 450 operations with 0% mortality. That's pretty difficult to do in cardiac, especially at such a high volume, and at an academic cardiac center which receives all the high risk patients that no one outside of academics is willing to operate on.

 

[45408]

One of our CT guys did a 12 hour redo-redo CABG X2 (mostly due to massive scar tissue). Did the first 8 hours on day one, left the chest open (but protected) and came back the next morning to finish up. The patient made it through the surgery just fine, and had no post op infection or any other complication. I must however add that leaving the chest open for another day is definitely not common practice around these parts, haven't seen it done since, and I'm not sure what compelled him to do so.

Twelve hours of surgery is a lot - for the surgeon and for the patient. Patients don't do well when they're under general anesthesia for that long. Breaking it up may not be the cool thing to do, but it might be the right thing. In traumas, they often pack the abdomen open for a "get in, stop the bleeding, get out" approach. A cold, coagulopathic trauma patient will only get worse the longer you're in there.

 

[SouthSideSteve]

One of our CT guys did a 12 hour redo-redo CABG X2 (mostly due to massive scar tissue). Did the first 8 hours on day one, left the chest open (but protected) and came back the next morning to finish up. The patient made it through the surgery just fine, and had no post op infection or any other complication. I must however add that leaving the chest open for another day is definitely not common practice around these parts, haven't seen it done since, and I'm not sure what compelled him to do so.

When you say "finish up" surely the patient was just so coagulopathic that definitive closure was not possible, or it would only mean a reentry later than night.

Unless he came back and finished the proximals, then he did the major part of the operation on the inital visit and the open chest was just due to bleeding.

In peds they leave chests open all the time and then come back and close a day or two later when appropriate. I've seen 20 or so adults that were left open (though they are usually 4x reops, VADS, or transplants).

I dont think you can fairly call that 1 procedure.

 

[SouthSideSteve]

My record is a 23hr implantation of a Berlin Heart.

Have also done 2 dissections and an emergency coronary back to back to back in just under 12 hrs with 2 teams and 2 rooms staggered.

I've grown numb to the 8hr VADs now.

 

[Buzz Me]

My record is a 23hr implantation of a Berlin Heart.

Have also done 2 dissections and an emergency coronary back to back to back in just under 12 hrs with 2 teams and 2 rooms staggered.

I've grown numb to the 8hr VADs now.

Are you a cardiac PA? SA?

I did a 19-hour cardiac case once. Painful!

 

[Toennis]

this is all nuts. surgeries are not supposed to be that long

 

[SouthSideSteve]

Are you a cardiac PA? SA?

I did a 19-hour cardiac case once. Painful!

Was an RN in CVOR, will graduate PA school next year.

 

[Black Surgeon]

When you say "finish up" surely the patient was just so coagulopathic that definitive closure was not possible, or it would only mean a reentry later than night.

Unless he came back and finished the proximals, then he did the major part of the operation on the inital visit and the open chest was just due to bleeding.

In peds they leave chests open all the time and then come back and close a day or two later when appropriate. I've seen 20 or so adults that were left open (though they are usually 4x reops, VADS, or transplants).

I dont think you can fairly call that 1 procedure.

If I recall correctly, the first 8 hours of that operation was spent dissecting through all the "redo redo" adhesions and creating a surgical field. The actual "procedure", proximal and distal was done one the next day. Not sure about the patient's bleeding propensity, I was a first year at the time and didn't ask any questions.

 

[SouthSideSteve]

If I recall correctly, the first 8 hours of that operation was spent dissecting through all the "redo redo" adhesions and creating a surgical field. The actual "procedure", proximal and distal was done one the next day. Not sure about the patient's bleeding propensity, I was a first year at the time and didn't ask any questions.

ok, thats crazy