avg. length of a the common gen. surgeries?

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EclecticMind

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I was wondering how long (on avg.) does the actual operation procedure last for some of the more common surgeries encountered by a general surgeon.

also, on avg., how many operations does a general surgeon perform of a given day? week?

Thank you.
 
It's hard to give numbers...every surgeon has a different speed depending on their comfort, training, and technical abilities as well as the level of difficulty and variability in the given case. That being said, here are some arbitrary average times (for the hypothetical average surgeon) with a reasonable range for a few commonly performed procedures. All times are in minutes.

Open hernia 45 (20-60)
Lap hernia 45 (15-60)
Lap chole 45 (10-120)
colon resection 90 (30-120)
mastesctomy 45 (30-60)
Lap Nissen 90 (30-120)
Appendectomy 30 (20-60)
Lap appy 30 (10-60)

Likewise, the number of cases that a surgeon does in a defined period vary greatly. On average, surgeons operate 3 days a week and see clinic patients 2 days a week.
 
thank you... that was just what I was wondering... very informative

what is considered "a long surgery" in regards to general surgery, and how long is "long?"
 
Some of the longer surgeries...

Esophagectomy: 3-5 hours
Total proctocolectomy with ileoanal pouch: 3-4 hours
Abdominal aortic aneurysm: 3-6 hours
Hepatic lobectomy: 3-6 hours
Whipple (pancreaticoduodenectomy): 3-6 hours

If you notice the trend here, most of these are at least 3 hours long. So I would suggest that anything over 3 hours is a long operation. Similarly, you'll notice that my list of more commonly performed procedures all hover around the 45 minute range.
 
thank you again FliteSurgn. I have wondered about this for a long time now, but have never seen it listed before me. thank you for time and information.

just fyi, I am going into my 3rd yr of med school this year. I've wanted to do surgery for a long time and I'm really interested in trauma. I have sort of a "love-hate" relationship with my desire to do surgery. In my heart, I feel like I would love it! But it's so easy to get discouraged when you hear some of the bad things that are said about a career in surgery... you know... "hours too long"; "work too hard"; "can't have a good family life"; etc., etc. You've heard it all before I'm sure.

Another thing that really gets me confused is that although I feel like I really would like being a surgeon, I don't want to spend every sec. of my entire career caved up inside an OR. But then there are those that claim that a "true surgeon" doesn't want to be anywhere BUT in the OR. I'm different because I would enjoy many of the other aspects of being a physician in general... like talking with patients, rounding, etc. And for me, the actual part of doing operations would be the icing on the cake. I hope that makes sense.

Oh well, thank you again for your help.
 
All those 3-6 hour operations listed above I've seen take more like 8 hours too - you never know when you enter the OR when you might get out.

There is much more patient interaction time in surgery than you probaby realize. All surgeons have clinics where they see thier potential pre-op patients refferred to them and thier post-op patients, some of which may come for many visits over a long period of time. And your patients will be in the hospital post-op, you are their doctor, so you will get what you want in talking to them and rounding on them every day. Part of the reason surgeons work such long hours is that they do all the patient care stuff like medicine doctors do, but they also have to be in the OR, so they end up doing all the rounding stuff before and after that (although rounding is much more efficient and focused than medicine rounding)

I also entered surgery residency excited about getting to have this role in patient care as well, but after getting through my first year...I still do like the talking to patients and families, but a little goes a long way and my most fun days are certainly the ones I am "caved up in the OR all day", as you say.
 
fourthyear said:
All those 3-6 hour operations listed above I've seen take more like 8 hours too - you never know when you enter the OR when you might get out.
Click to expand...
Legend has it that one of our VA surgeons took 24 hours to do a Whipple and about the same amount of time to do an Ivor-Lewis. Thankfully, the VA hospital decided that he shouldn't be doing those cases anymore. I met with some resistance from the OR nurses that remembered those cases when I put on my first transhiatal there. They were so thrilled when my average esopagectomy time was under 4 hours.

It's unusual for any of the listed cases to last much longer than I mentioned. Sure if you run into a problem things may take a little longer, but if surgeons consistently take longer than that you really have to question whether they have the skills necessary to do those cases.
 
thank you both for your thoughts and info. It has been very helpful. Thank you!
 
smq123 said:
I scrubbed in on a 7 hour parathyroidectomy once. That was pretty bad.
Click to expand...

😱

WTF? Did you guys start at the toes and head north?

Oh... (Just remembering...) Did you guys have to crack the chest or something?
 
Blade28 said:
My record is a 19-hour redo-redo AVR. 😱
Click to expand...

At least that can be fairly complicated. My record is a 14-hour laparotomy for a patient who had about six laparotomies in a 2 month span. For what? Retained foreign body. Oops. You'd never think it, but those blue towels can really mess things up inside.
 
Castro Viejo said:
😱

WTF? Did you guys start at the toes and head north?

Oh... (Just remembering...) Did you guys have to crack the chest or something?
Click to expand...

No. 🙁 I wish we had. That would have made the 7 hours worthwhile, at the very least.

The attending is just a very, very, very careful surgeon.... He used the nerve stimulator on everything, even things that were clearly not nerve tissue. And the parathyroids weren't easy to find in that particular patient.

What was worse was that this case STARTED at 3 PM.
 
smq123 said:
No. 🙁 I wish we had. That would have made the 7 hours worthwhile, at the very least.

The attending is just a very, very, very careful surgeon.... He used the nerve stimulator on everything, even things that were clearly not nerve tissue. And the parathyroids weren't easy to find in that particular patient.

What was worse was that this case STARTED at 3 PM.
Click to expand...

:laugh: Uh... And lemme guess... He thinks Sestamibis are for losers, right?
 
Castro Viejo said:
My record is a 14-hour laparotomy for a patient who had about six laparotomies in a 2 month span. For what? Retained foreign body. Oops. You'd never think it, but those blue towels can really mess things up inside.
Click to expand...

Ouch!

Key words for this dictation:

*Frozen abdomen
*Socked in
*Gossypiboma
*Adhesiolysis
 
Blade28 said:
Ouch!

Key words for this dictation:

*Frozen abdomen
*Socked in
*Gossypiboma
*Adhesiolysis
Click to expand...

Yeah... My Chief Resident at the time called it "a case for Drs. Jacoby and Meyers."
 
I've been lucky so far in my 3rd year surgery rotation -- longest was a hand-assisted lap nephrectomy, which was 5.5 h, but all kinds of awesome. I'm not sure how I'd deal with the 7+ hour surgeries -- I like eating and drinking and so forth. My friend was scrubbed for 10 hours for a cervical laminectomy.
 
My records:

14 hour liver transplant as a resident. And it was an UGLY 14 hours considering about 9-10 of it was spent attempting hemostasis...and a couple hours were spent in what was essentially a continuous code (patient did make it out of OR).

12 hour plastics case as a student (I think it was an ORIF of LeFort III fx and facial reconstruction)
 
The first time I ever set foot in the OR was a C-section...I had already heard how short those were compared to "real surgeries". Anyway, it was 3:30 in the morning, and we were in there for a whopping 4.5 hours. I thought for sure I might die when I got to general surgery if that was a super short surgery! Needless to say I soon found out that was not your typical C-section...
 
butterfly0660 said:
The first time I ever set foot in the OR was a C-section...I had already heard how short those were compared to "real surgeries". Anyway, it was 3:30 in the morning, and we were in there for a whopping 4.5 hours. I thought for sure I might die when I got to general surgery if that was a super short surgery! Needless to say I soon found out that was not your typical C-section...
Click to expand...

Gee, I hope the patient or the baby didn't die.
 
Yeah, tell me that all that time wasn't spent trying to get the baby out!

Tell me it was for postpartum bleeding or difficulty in closing after the baby was out!

😱
 
Blade28 said:
Yeah, tell me that all that time wasn't spent trying to get the baby out!

Tell me it was for postpartum bleeding or difficulty in closing after the baby was out!

😱
Click to expand...

No... The baby was out. Even they can't F-that up.

It was probably for trying to figure out where all that stool and succus came from. 🙂
 
Blade28 said:
Yeah, tell me that all that time wasn't spent trying to get the baby out!

Tell me it was for postpartum bleeding or difficulty in closing after the baby was out!

😱
Click to expand...

It was purely due to incompetence...the attending wasn't present for much of it, and it took the resident forever to get into the uterus, then he kept sticking the scrub tech with needles....there was some excessive bleeding once the baby was out that took a little while to get control of, but it took him an hour and a half to close (and we stapled the skin!)
 
Castro Viejo said:
No... The baby was out. Even they can't F-that up.

It was probably for trying to figure out where all that stool and succus came from. 🙂
Click to expand...

Gynes need to learn to call in a general surgeon when they aren't sure what's going on! :idea:

:meanie:
 
butterfly0660 said:
It was purely due to incompetence...the attending wasn't present for much of it, and it took the resident forever to get into the uterus, then he kept sticking the scrub tech with needles....there was some excessive bleeding once the baby was out that took a little while to get control of, but it took him an hour and a half to close (and we stapled the skin!)
Click to expand...

Sigh...don't get me started on these so-called "surgeons."
 
Winged Scapula said:
Wondered when it was going to start.

How long does it take to get into the uterus? So what if the baby has a cut across his little head? Its practically fetal skin..it'll heal!:meanie:

(don't let Old Bear see this)
Click to expand...

Don't worry, I'm not going to start.

I'm just going to bite my tongue (despite this being the Surgery forum 🙂 ) and be grateful the mom and baby were OK.
 
The longest case ive seen (while shadowing) was an 8 hour CABG. I was shocked, since all the others I had seen before then were in private practice, so things were quite a bit faster with no residents or fellows.
 
smq123 said:
I scrubbed in on a 7 hour parathyroidectomy once. That was pretty bad.
Click to expand...

14 hour re-do parathyroidectomy (thankfully not my case, but that resident has not been the same ever since)
 
BlackSails said:
The longest case ive seen (while shadowing) was an 8 hour CABG. I was shocked, since all the others I had seen before then were in private practice, so things were quite a bit faster with no residents or fellows.
Click to expand...

Even with the world's worst resident or fellow, it shouldn't take 8 hrs.😳
 
Winged Scapula said:
Even with the world's worst resident or fellow, it shouldn't take 8 hrs.😳
Click to expand...

I know, I think it had to do with a series of equipment failures (endoscopic vein harvester not working, wait for a new one, and some other problems. The attending was furious by the end)

Yeah, none of the others ive seen have taken that long. The average at the private practice hospital was probably around 2.5-3 hours, while the average at the academic center was probably around 4-4.5ish.
 
Endoscopic vein harvester? We just do it all by hand at our county hospital!

The PA works on the saphenous vein while the fellow starts cracking the chest. The resident will either help the PA (if the attending's helping the fellow), or will occasionally help the fellow open.
 
Bitsy3221 said:
14 hour re-do parathyroidectomy (thankfully not my case, but that resident has not been the same ever since)
Click to expand...

Ouch. 🙁

I think that after that marathon case, I probably would have crawled home, curled up in the fetal position in some corner, and rocked for a few hours.
 
Blade28 said:
Endoscopic vein harvester? We just do it all by hand at our county hospital!

The PA works on the saphenous vein while the fellow starts cracking the chest. The resident will either help the PA (if the attending's helping the fellow), or will occasionally help the fellow open.
Click to expand...

At the academic center, the fellow would endoscopically get the saphenous vein, while the PA would harvest the radial artery. Sometimes, on fat patients or whatever, the attending would take the radial artery himself.
 
3 hour mastectomy today

i was supposed to stay scrubbed in for the reconstruction portion but as soon as I saw my resident break scrub, I too was ripping my gown off

my attention span is definitely way too short to enter surgery (I saw another student scrubbed into an 8-hour anterior resection...I'd start screaming by the 5 hour point)
 
KurosawaRhap said:
my attention span is definitely way too short to enter surgery (I saw another student scrubbed into an 8-hour anterior resection...I'd start screaming by the 5 hour point)
Click to expand...

Don't forget it's totally different when you're operating, versus watching or just assisting.

I was impatient during my MS-III rotation as well...but it's completely different when you're a resident and are doing the case.

Just something to keep in mind.
 
Blade28 said:
Radial artery? 😕 We don't use that here. 🙂
Click to expand...

Supposedly, arteries in general have a lower occurance of intimal hyperplasia. At private practice hospital, they didnt use the radial, just saphenous and IMA.
 
BlackSails said:
Supposedly, arteries in general have a lower occurance of intimal hyperplasia. At private practice hospital, they didnt use the radial, just saphenous and IMA.
Click to expand...

Well, yeah, usually we use the LIMA along with the saphenous veins.

The radial artery can indeed be harvested - I've read about its practice and history in various journals - we just don't do that here.
 
this post is a question for see user below and anyone else who can help
i have a retained sponge in me and am having a hard time finding a surgeon who knows much about it and willing to remove- can anyone help???? its been in there 7 years so its probably a mess

Castro Viejo
Papa Clot Buster



Status: Attending
Join Date: Jun 1999
Posts: 3,746
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Quote:
Originally Posted by Blade28
My record is a 19-hour redo-redo AVR. 😱

At least that can be fairly complicated. My record is a 14-hour laparotomy for a patient who had about six laparotomies in a 2 month span. For what? Retained foreign body. Oops. You'd never think it, but those blue towels can really mess things up inside.
 
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)
 
bellasmom said:
this post is a question for see user below and anyone else who can help
i have a retained sponge in me and am having a hard time finding a surgeon who knows much about it and willing to remove- can anyone help???? its been in there 7 years so its probably a mess

Castro Viejo
Papa Clot Buster



Status: Attending
Join Date: Jun 1999
Posts: 3,746
10year.png



icon1.png

Quote:
Originally Posted by Blade28
My record is a 19-hour redo-redo AVR. 😱

At least that can be fairly complicated. My record is a 14-hour laparotomy for a patient who had about six laparotomies in a 2 month span. For what? Retained foreign body. Oops. You'd never think it, but those blue towels can really mess things up inside.
Click to expand...


tumblr_lrbehw6OuY1qhi0is.jpg
 
WOAH!! Sick times. 😱

Not a resident yet, but...


  • Quickest surgery: 5 minutes (exactly) for an open appy. I think it was 5am and attendings wanted to do it quickly, so resident and I just stared in awe.
  • Longest surgery: 6-hour Whipple. Loved every minute. :meanie:

Not as impressive as some of you though.
 
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