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Radiation Exposure During Surgery

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almo0318

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Can anyone give a ranked list of surgery specialties and (estimated) amount of exposure to radiation? Are there any fields that are not really exposed at all? I am a third year medical student who wants to be a surgeon of some sort but radiation exposure freaks me out. My orthopedic rotation had significantly more radiation exposure than my general surgery rotation. It made me realize it is something I find important when I decide on my specialty. Any insight would be greatly appreciated.
 

TraumaLlamaMD

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Ortho and vascular are the two big ones that come to mind. Most of my general surgery attendings see radiation very rarely - only if they do port insertions or cholangiograms for the most part. That said, in residency I have done my fair share of lead wearing between vascular and trauma rotations.
 
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DoctwoB

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Ortho and vascular are the two big ones that come to mind. Most of my general surgery attendings see radiation very rarely - only if they do port insertions or cholangiograms for the most part. That said, in residency I have done my fair share of lead wearing between vascular and trauma rotations.

Agreed that Ortho and Vascular will be 1/2. Urology probably comes in 3rd due to fluoro in cysto (mostly kidney stone cases), but our times tend to be much lower then in a Angios. And if that still worries you you can tailor your career away from stones towards onc, peds, female, infertility, etc.
 
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OtoHNS

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ENT has basically no radiation exposure in the OR.
 
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evilbooyaa

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Any surgery or specialty that uses continuous fluoro a lot (not just spot films) will be the biggest contributors. Vascular, IR, Ortho, NSG come to mind. GSurg mainly for cholangios.
 

TypeADissection

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    Can confirm. I eat a lot of radiation on an almost daily basis. I used to think multivessel fenestrated cases were so cool (and they are) minus the part where I’m in lead for hours on end getting my nuts nuked.
     
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    Jolie South

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    Can confirm. I eat a lot of radiation on an almost daily basis. I used to think multivessel fenestrated cases were so cool (and they are) minus the part where I’m in lead for hours on end getting my nuts nuked.
    It’s all about that short neck indication with endo anchors. :banana:
     
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    atomi

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    Low dose radiation is good for you bro
     
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    TypeADissection

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    Why does @atomi saying "radiation is good for you" sound so funny, yet so true?

    Bc it is. Gotta build a tolerance to it first. Start with low doses and work your way up. Eventually you don’t need lead.
     
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    evilbooyaa

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    Low dose radiation is good for you bro
    Why does @atomi saying "radiation is good for you" sound so funny, yet so true?

    We were actually having a brief discussion about the hormesis model (google it) in the Rad Onc forum. I mean not a super serious one, but one none the less.
     
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    vhawk

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    Bc it is. Gotta build a tolerance to it first. Start with low doses and work your way up. Eventually you don’t need lead.
    My favorite part about being the senior trauma resident during residency was watching people scamper and scurry out of the room during the portable cxr. Thats like 3 bananas worth of radiation, bro, i think youll be fine.
     
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    TypeADissection

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    My favorite part about being the senior trauma resident during residency was watching people scamper and scurry out of the room during the portable cxr. Thats like 3 bananas worth of radiation, bro, i think youll be fine.

    I see your 3 bananas and raise you 2 cross country flights from NY to LA
     
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    DoctwoB

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    We were actually having a brief discussion about the hormesis model (google it) in the Rad Onc forum. I mean not a super serious one, but one none the less.

    The problem is that low dose being beneficial data comes from cell line studies. Human studies of nuclear power workers, A bomb survivors, and CT recipients have shown even low doses increase cancer risk.
     
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    deleted950463

    There are supposed human retrospective studies too. Just not on reputable journals
     

    dpmd

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    Any surgery or specialty that uses continuous fluoro a lot (not just spot films) will be the biggest contributors. Vascular, IR, Ortho, NSG come to mind. GSurg mainly for cholangios.
    Eh, I don’t really do cholangios anymore because I'm not one of those who does routine ones for the extra reimbursement (or whatever reason they claim they do it for) and anyone I think might have a cbd stone is probably getting an ercp beforehand or might as well just watch labs after and get it done postop. Given that I can't do a laparoscopic cbde the false positive rate is enough for me to seldom choose an intraop cholangiogram.

    I do however, do ports with fluoro. Despite religiously wearing my radiation badge I am consistently shown to have no measurable exposure on the reports.
     
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    So there is no radiation dose that’s a “minimum” required to get cancer —what is known as the LNT (linear non-threshold) theory. You can get cancer from small or large amounts of radiation. So... Don’t worry about it, and do the profession that interests you.


    Sent from my iPhone using SDN mobile
     

    DoctwoB

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    So there is no radiation dose that’s a “minimum” required to get cancer —what is known as the LNT (linear non-threshold) theory. You can get cancer from small or large amounts of radiation. So... Don’t worry about it, and do the profession that interests you.


    Sent from my iPhone using SDN mobile

    Another way of thinking of it is that by virtue of being alive you have a roughly 30-35% lifetime risk of cancer. For a 40 year old man, a dose of 150mSV (roughly 15 single phase CT scans, which would be a heck of a lot of secondary fluoro exposure) would have a roughly 1% risk of causing cancer. So relatively speaking a small increase in risk. In absolute risk, well it’s significant if you’re the 1%. Is avoiding that risk worth changing your career? Up to you.
     
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