Long Surgery + Bathroom Needs

[Zorlio]

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Not sure where to ask this, but -

Let's say an operation takes like 7 hours and around hour 3, the main doc has to really go to the bathroom - what happens? Do they just let someone hold the patient stable while they go do their thing or what?

 

[mysophobe]

They break scrub and go. This isn't too uncommon. We have a vascular surgeon that breaks to get a drink of soda everytime they give heparin, since we have to wait 5 mins to clamp anyway.

 

[SoCuteMD]

Ok, not to hijack, but what about the med student who has to pee?

I was on a medical center bus a year or so ago and I remember hearing some surgery residents joke about "keeping the tank 1/4 low." I almost laughed out loud.

 

[mysophobe]

Gotta hold it. I've gone a good 10 hours without anything to eat, drink, or bathroom break. Sucks ass.

 

[SoCuteMD]

I can just feel the kidney stones now...

 

[neutropenic]

You try not to, but if you have to go...you have to go.

I mean, after all, it's hardly ever the case they really need the medical student.

 

[Smurfette]

10 hours without peeing? Wait until you're a resident. I have actually gone an entire 30ish hour call without going once. I only ate/drank once, so I was incredibly dehydrated and thus didn't feel the urge to go...realized once I got home that I never went at all during the entire day of call.

 

[mysophobe]

Yeah, I've done that before. It sucks. I try to keep a bottle of water in my lab coat or around me at all times, but it's hard sometimes. I've gotten used to it pretty much, though.

 

[AmoryBlaine]

Yeah, I've done that before. It sucks. I try to keep a bottle of water in my lab coat or around me at all times, but it's hard sometimes. I've gotten used to it pretty much, though.

Wow, and to think, someone in the class above me was giving me advice for surgery -- "Stay hydrated."

Seriously though, if an otherwise good M3 asked permission for a trip to the head do you think the residents and attendings would make fun of them while they were gone for lack of sphincter tone?

 

[Skialta]

Honestly, you don't have enough time to drink that much to make much urine. It is ironic that we freak when our patients don't make 50 ml/hr and at the same time you might only make 150 mls in 10 hours because your standing in surgery all day.

 

[mysophobe]

Hah, yeah. I dunno, when people leave the room to pee while I'm there, no one even says anything. We kind of forget about it until they come back, at which time we promptly joke about their weak bladder.

 

[DarksideAllstar]

= Foley

 

[OSUdoc08]

Not sure where to ask this, but -

Let's say an operation takes like 7 hours and around hour 3, the main doc has to really go to the bathroom - what happens? Do they just let someone hold the patient stable while they go do their thing or what?

You just go. Make sure to aim away from the sterile field.

 

[Happy613]

I have heard of some attendings getting foleys put in for super long cases. I think it might just be an urban legend though.... the longest case I scrubbed on was about 8 hours, I have no idea what I would have done if I really had to go to the bathroom, I think you often get really dehydrated in the OR since its usually hot and you are on your feet, which has got to help.

 

[Wrigleyville]

They leave, pee, and come back. You can do the same, just ask permission first and go do your thing. It's not like they're going to say no and have you piss your pants.

 

[mysophobe]

I have heard of some attendings getting foleys put in for super long cases. I think it might just be an urban legend though.... the longest case I scrubbed on was about 8 hours, I have no idea what I would have done if I really had to go to the bathroom, I think you often get really dehydrated in the OR since its usually hot and you are on your feet, which has got to help.

I've heard people tell that story, but I've never met anyone that even knows anyone that has done it. It's perfectly acceptable practice to break scrub, go pee, and come back. It's not as though the entire OR staff is leaving at the same time. Operating while you're completely distracted with the urge to urinate is more dangerous than extending the surgery by a minute and a half.

 

[billydoc]

I'll just wear "ooups I craped my pants" diaper
But seriously lol, what do I do if I'm more or less controlled diabetic. i don't ever dream of being a surgeon anymore, but how the hell do I get through those surgical rotations and stuff, w/o ticking everybody off. Gotta eat to maintain upright posture. Any advise?

Thanks

 

[JunkintheTrunk]

what about us that will need caffeine to survive these long shifts? 2 cups, and i'm on the potty in like 10 mins. sx should be fun for me 😳

 

[njbmd]

Not sure where to ask this, but -

Let's say an operation takes like 7 hours and around hour 3, the main doc has to really go to the bathroom - what happens? Do they just let someone hold the patient stable while they go do their thing or what?

Hi there,
You go before you start the case. Once in there, you are wearing a gown over your scrubs and standing under bright lights that are hot. You start to sweat which takes care of your need to urinate. Most patients are also under a warming device which heats the surgeon too. Most surgeons are covered with sweat at the end of a long case which means that the surgeon is usually dehydrated as opposed to needing to urinate. There is nothing like an ice cold Diet Coke after a long case. (Just like a cold beer after a long ski run.) 👍

You should always visit the restroom before a case. You don't wait for Mother nature to call, you keep her occupied so that she doesn't call. Most of the circulating nurses will give you a sip of something to keep the dehydration down too.

njbmd 🙂

 

[Beau Geste]

I'm with the other poster in peeing every 10 minutes. I'm not diabetic, but seriously, I go a lot.

It sounds gross, but there's not much worse than having to go potty and not being able to, so I'd probably break down and wear the depends. It's not like that part of you is sterile anyway!

 

[mysophobe]

You don't have time to drink enough to where you'd be peeing all the time. If you're peeing every 10 mins without significant fluid intake, you'd better be sure you don't have diabetes or another underlying illness.

Anyway, all joking aside, most cases don't last 7 hours. Most cases last 45 mins to 3 hours depending on the case and the surgeon. Only the bigger cases will last upwards of 7 hours, and no one will harrass or think less of you for breaking to go pee. Attendings do it all the time. In fact, if they do it during the case, it wouldn't be a bad idea to just break and go when they do.

 

[King Arthur]

guys, don' t be so freakin nuts. if you have to go to the bathroom, just say "i gotta go to the bathroom, i'll be right back." unless your attending is Adolf Hitler Jr, MD they won't give you any trouble.