Avg Length of surgeries in different specialties

[EChipouras]

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Hi,

I was hoping to get an idea re: the avg length of surgeries between the specialties. Neurosurg, i've heard is the longest, but i don't have a reference frame to compare it to--anybody have a weblink or input on this? (couldn't find it on search)

Thanks.

 

[Winged Scapula]

Hi,

I was hoping to get an idea re: the avg length of surgeries between the specialties. Neurosurg, i've heard is the longest, but i don't have a reference frame to compare it to--anybody have a weblink or input on this? (couldn't find it on search)

Thanks.

Hard to say because there is such a wide variation of procedures and the time it takes. For example, I have done uncomplicated Whipples with a confident and decisive surgeon in 4 hours and I have also done Whipples with a less than decisive surgeon which took 12 hrs.

Ortho has some extremely length procedures, as does Neuro, Gen Surg, ENT, etc.

I think all fields have short cases and some horrendously long ones. I much prefer lots of shorter procedures over one long one and chose a field which lends itself to that.

 

[Blade28]

Did you do a search?

This thread was found by doing a search with the keyword "length."

 

[-Goose-]

Are you talking about private practice or academics?

As KC said, PP (and academic) ortho & neurosurgery are especially noted for long operations. Even a simple TKA can take a long time.

If you want short procedures, I'd check out ENT.

Tubes take 5 minutes. Tonsillectomies/adenoidectomies are very quick as well. This is "bread and butter" stuff.

Of course, ENTs do big whacks too, if thats you're thing. HNS does 12 hour tissue transfers, etc. Sinus surgery can be lengthy as well.

 

[H_Caulfield]

Anyone have enough experience with neurosurgical cases to say anything general about length of operations? I spoke to a resident the other day who had supposedly just been in on a tumor case from 8am to midnight. He was too pissed off to comment any further; I lost him. Hopefully this is a rare occurrence...?

 

[Winged Scapula]

Anyone have enough experience with neurosurgical cases to say anything general about length of operations? I spoke to a resident the other day who had supposedly just been in on a tumor case from 8am to midnight. He was too pissed off to comment any further; I lost him. Hopefully this is a rare occurrence...?

It would entirely depend on where the tuimor was and whether or not it was invading certain structures. I have spent hours and hours dissecting tumors off the cava or or the facial nerve (during an ENT rotation); then again I've had others just pop out.

I'm sure its the same in Nsgy...16 hrs is most likely very unusual. But I'll bet the case "started" at 0800, which meant the patient was in the room, but positoning, etc. took another hour, they made have had to wait for some frozens, etc. If the tumor was deeply embedded or encasing vital structures, it can take a heck of a lot of time to get it all out. These types of surgery also involve a lot of time deciding how to proceed when you come across unexpected findings.

 

[H_Caulfield]

Thanks for your input, Dr. Cox. That was helpful.

 

[earboy]

It would entirely depend on where the tuimor was and whether or not it was invading certain structures. I have spent hours and hours dissecting tumors off the cava or or the facial nerve (during an ENT rotation); then again I've had others just pop out.

This is pretty routine in academic centers who do a lot of head and neck oncology. At my institution, it is common to begin a case at 7am and see it finish around midnight, some later, and some obviously earlier.

If you want shorter cases on average, try urology. THey have some longer ones, but many of their procedures are 4 hrs or less. Apart from cancer in ENT, most of our cases are shorter too. Ave. neurosurgery cases are longer, yes, but totally depends on what kind of cases you're doing. If you're implanting epidural pumps or thalamic stimulators or doing run of the mill spine stuff, that won't take so long. Cancers, aneurysms, some pituitary tumors, spinal epidural tumors that need alot of dissection will keep you in the OR for a long time.

In general surgery, do breast or endocrine. Those are fairly shorter cases. Some of the MIS stuff too. Bottom line, every field has its long and short. You can choose.

 

[Pir8DeacDoc]

well said above...


If you want crazy long cases, you can find that in any field. If you'd prefer shorter procedures, you can find those too.

 

[ddmo]

The problem with estimating length is that surgery is like a box of chocolates...

Sometimes things go your way and sometimes they don't. This is especially true for cases where you don't know what needs to be done until you get in there.

For example, when doing a hip replacement revision, maybe you can leave the femoral stem and pop a new head on it with a liner, very quick. Whereas sometimes you need to remove the stem, maybe it pops out with one slap of a slap hammer, awesome... or worse, it cannot be removed no matter how much slap hammer action you partake in and after 3 osteotomies placing a new stem and cabling it back into place you've just added 4 hours onto something that could have taken 10 minutes.

The same can be said in general surgery, when you open the abdomen and see adhesions all over and suddenly it becomes a 6 hour lysis of adhesionathon.

These scenarios are common across all fields of surgery, it's just the nature of the beast.

 

[powermd]

At Columbia the following is typical. Variation is by surgeon and complexity of case.

Neuro cases:
Tumor 3-5 hrs typical, have seen up to 15 hrs
Aneurysm 4-8 hrs
Pituitary 3 hrs
SDH evacuation 2 hrs
VP shunt 1-2 hrs
Burr hole 45 min

Cardiac:
LVAD 7 hrs
Uncomplicated CABG 3V, single valve, transplant 4hrs
Lung txp 6-8 hrs

Vascular:
Liver txp 5-10 hrs
Kidney txp (recip) 4 hrs
Whipple 5-8 hrs
Peripheral angioplasty 1 1/2-3 hrs
AAA (open) 4-6 hrs
AV fistula 2 hrs

Ortho:
Total shoulder 5-7 hrs
SLAP repair 2-3 hrs
Single total knee 3-4 hrs
Knee arthroscopy/meniscectomy 45-60 min

GU:
Radical prostatectomy 5 hrs
Partial nephrectomy 4 hrs
TURP 2-3 hrs
Robot prostate 3 hrs
ESWL 45-60 min
Stents 30 min

Gyn:
TAH 3-5 hrs
Myomectomies 2-4 hrs

GS:
Appy (lap) 1 hr
Chole (lap) 1 1/2 hr typical, seen 4-5 hrs complicated/teaching
Thyroid 2 hrs

ENT:
FESS 1-2 hrs
Flap 5-8 hrs

 

[Blade28]

Cardiac:
LVAD 7 hrs
Uncomplicated CABG 3V, single valve, transplant 4hrs
Lung txp 6-8 hrs - 3-4 hours

Vascular:
Liver txp 5-10 hrs - 4-6 hours
Kidney txp (recip) 4 hrs - 3 hours
Whipple 5-8 hrs - 3-4 hours
Peripheral angioplasty 1 1/2-3 hrs
AAA (open) 4-6 hrs - 3-5 hours
AV fistula 2 hrs

Our numbers are similar...except for the CT/Vascular stuff which I noted above.

 

[H_Caulfield]

At Columbia the following is typical. Variation is by surgeon and complexity of case.

Neuro cases:
Tumor 3-5 hrs typical, have seen up to 15 hrs
Aneurysm 4-8 hrs
Pituitary 3 hrs
SDH evacuation 2 hrs
VP shunt 1-2 hrs
Burr hole 45 min

Cardiac:
LVAD 7 hrs
Uncomplicated CABG 3V, single valve, transplant 4hrs
Lung txp 6-8 hrs

Vascular:
Liver txp 5-10 hrs
Kidney txp (recip) 4 hrs
Whipple 5-8 hrs
Peripheral angioplasty 1 1/2-3 hrs
AAA (open) 4-6 hrs
AV fistula 2 hrs

Ortho:
Total shoulder 5-7 hrs
SLAP repair 2-3 hrs
Single total knee 3-4 hrs
Knee arthroscopy/meniscectomy 45-60 min

GU:
Radical prostatectomy 5 hrs
Partial nephrectomy 4 hrs
TURP 2-3 hrs
Robot prostate 3 hrs
ESWL 45-60 min
Stents 30 min

Gyn:
TAH 3-5 hrs
Myomectomies 2-4 hrs

GS:
Appy (lap) 1 hr
Chole (lap) 1 1/2 hr typical, seen 4-5 hrs complicated/teaching
Thyroid 2 hrs

ENT:
FESS 1-2 hrs
Flap 5-8 hrs

Wow! This is great; thanks a lot, guys. People have a tendency to take their exceptional surgical experiences and use them to scare the hell out of prospective surgeons. I'll have to start steering clear of disgruntled residents at school.

 

[Winged Scapula]

Wow! This is great; thanks a lot, guys. People have a tendency to take their exceptional surgical experiences and use them to scare the hell out of prospective surgeons. I'll have to start steering clear of disgruntled residents at school.

Definitely a good idea.

Even some of the times above are long (ie, 1.5 hrs for a gallbladder is probably in the hands of a junior resident; I won't tell you my record time but its significantly shorter); as noted it all depends on the surgeon, the patient, and many other factors.