Length of various procedures

[sean wilson]

It's been noted that a liver transplant can run eight hours or so. I would have thought that they would be much longer, and it has me wondering how long things generally run. Specifically, heart, liver, pancreas, etc. While many things vary, including the number of organs being transplanted or the complexity of a given surgery (neuro, in particular seemed to run long in med school), but there should be some averages we can toss around here, right?

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[cchoukal]

I asked one of my staff once what his longest case was. He said it was a liver transplant that took 40 hours. He said he worked 24 hours, went home to sleep for 8, and then came back and finished the case. I have no evidence as to the validity of the story, but that's what he said.

 

[InGasWeTrust]

Livers can be lenghthy!


Im just a tern, but I am in the SICU at Miami. One of the busiest liver transpalnt centers in the world.........(everyone gets a liver...lol) The longest one I know of was 31 hours or so..


On an unrelated note I can now place a central line in 15 minutes!!!!( that is total time from running to the omnicell getting all the supplies to throwing the last suture in.......

 

[InGasWeTrust]

Livers can be lengthy!


Im just a tern, but I am in the SICU at Miami. One of the busiest liver transpalnt centers in the world.........(everyone gets a liver...lol) The longest one I know of was 31 hours or so..


On an unrelated note I can now place a central line in 15 minutes!!!!( that is total time from running to the omnicell getting all the supplies to throwing the last suture in.......

 

[UTSouthwestern]

On an unrelated note I can now place a central line in 15 minutes!!!!( that is total time from running to the omnicell getting all the supplies to throwing the last suture in.......

You'll get even faster than that in just your first anesthesia year.

 

[InGasWeTrust]

UTSouthwestern,

I hope so, I think my biggest slow down is having to run to the omnicell and grab everything. If I could have everything at the bedside I am sure it would shave a good 3-4 minutes off my time. Even my fellows get a kick out of how fast I can go as just a lowly tern.

 

[jetproppilot]

Liver transplants are generally lengthy, but they don't have to be REALLY long. Essentially the speed of an operation is mostly dependent on surgeon prowess. The transplant program in my city has a transplant surgeon who does livers in 4-5 hours, with a very high success rate. Most liver transplants start whenever the organ arrives (read 0300 inevitably). This dude, because of his speed, starts around 0630 regardless of what time the organ arrives, since he knows he'll have the liver reperfused in less than half the time of most transplant surgeons.

 

[jetproppilot]

15 minutes is great for a resident. As UT said, you will get faster in private practice. One of my partners and I were bored one busy day that involved alot of "lining". Fastest line that day? 3 minutes 20 seconds. The start point was tearing off the top of the central line kit. The end point was the second (and last) suture. The time did not include flushing the ports. (SEE? We're still easily amused like 13 year olds)
Fastest "lining the heart" in our group was 11 minutes: 16 gauge peripheral, arterial line, and 9.0 Fr right IJ cordis.

On an unrelated note I can now place a central line in 15 minutes!!!!( that is total time from running to the omnicell getting all the supplies to throwing the last suture in.......[/QUOTE]

 

[UTSouthwestern]

Jet, at one of the institutions we rotate at, the maximum allotted time from time rolling into the room to skin cut time is 20 minutes. I was fortunate to do almost 100 hearts and 16 livers there in two months and it just accelerated my learning curve beyond what I thought it could be.

That 20 minutes included the a-line, PIV, cordis, Swan, and TEE. There's a reason why they have 4 heart rooms that turn over 4-5 hearts per room every day.

 

[jetproppilot]

MAN, UT, you know you're a stud when you can do all that in 20 minutes. Working at a place like you described should be mandatory at some point in ones career- you feel the pressure and you adapt, becoming BIGGER...FASTER.......STRONGER..

Awesome.

Jet, at one of the institutions we rotate at, the maximum allotted time from time rolling into the room to skin cut time is 20 minutes. I was fortunate to do almost 100 hearts and 16 livers there in two months and it just accelerated my learning curve beyond what I thought it could be.

That 20 minutes included the a-line, PIV, cordis, Swan, and TEE. There's a reason why they have 4 heart rooms that turn over 4-5 hearts per room every day.

 

[jetproppilot]

I was fortunate to do almost 100 hearts and 16 livers there in two months and it just accelerated my learning curve beyond what I thought it could be.

Just a comment on your excellent observation, UT, about accelerating your learning curve beyond what you thought it could be.
We all should keep this in mind and strive to be better. How many staff surgeons/anesthesiologists at teaching institutions are fast and efficient at what they do? Talking from my personal experience, there is a drastic difference in the skills of those exposed to a busy, efficient oriented practice verses those of non-efficient (read academic) envoronments.
I had to make the transition from a 3 hour TAH-BSO to a 45 minute TAH-BSO, a 25 minute D&C to a 4 minute D&C, a seven hour CABG to a 3 hour CABG. I couldn't take my leisurely time lining hearts/ doing inductions/blocks etc Those surgeons (and their consultant anesthesiologists) became quicker and more efficient. We can become as good as we want to be at our craft.

 

[UTSouthwestern]

MAN, UT, you know you're a stud when you can do all that in 20 minutes. Working at a place like you described should be mandatory at some point in ones career- you feel the pressure and you adapt, becoming BIGGER...FASTER.......STRONGER..

Awesome.

This group is one of the most talented groups in the country. We (the residents) become the delaying factor and we learn that we get at most two passes at a line or the TEE before the attending takes over. Fortunately, they teach you when you miss something/take too long and the tips they pass on make you become 10 times more efficient.