Surgery: Shorter is better

jama logoIn a recent study published in the Journal of the American Medical Association (JAMA), researchers found that longer surgery duration is associated with increased risk of blood clots forming in the leg and leading to a pulmonary embolism. What does this mean for you?

A little background

Venous Thromboembolism (VTE) is the process by which a person sitting or lying still for a very long period of time (surgery or on a long plane flight) develops blood clots in the legs that can travel through the veins to the heart and lungs, leading to difficulty breathing and possible death. This doesn’t happen to everyone just because they have surgery or sit for long periods of time. Of course we know lots of people that have surgery or take many long flights without this problem. But depending on certain genetic and/or medical factors, blood clots and VTE occur in particularly susceptible people.

In the study above, doctors found that one factor that can lead to an increased risk of forming blood clots that travel to the heart and lungs (VTE), is due to prolonged times in the operating room. You might think that if you have a surgical procedure, it’s best if the surgeon is slow and methodical to avoid mistakes. Unfortunately that is not the case. The longer you are laying flat on an OR table and not moving, blood pools in the leg veins, forms clots and can travel to the heart and lungs, possibly leading to death.

Surgeons do apply garments/stockings to the feet and legs to reduce the chance of developing clots in the legs but one additional intervention to reduce the chance of VTE is to shorten the operation. This is easier said than done for some surgeons or some operations. A liver transplant is a long operation – no way around it. But maybe removing a gall bladder can be done quickly and avoid VTE. Maybe a facelift that takes 3 hours is better for your health than one that lasts 10 hours.

This study suggests that you need to find a surgeon that can do your operation in as short a time as possible. That’s almost impossible to determine ahead of time. You can certainly ask your surgeon how long the operation takes them but you’d have to ask multiple surgeons during multiple consultations to determine the benchmark. Additionally, you must weigh how fast they are with how many complications they have. While I believe surgery that takes an unnecessarily long time to complete is detrimental to the patient, there’s a balance between a short operation and one that is too short and leads to sloppy work. As Albert Einstein once said, “make things as simple as possible, but not simpler!”

Here’s another quote I’m fond of: You can have a fast good surgeon, a fast bad surgeon and a slow bad surgeon…notice there’s no such thing as a slow good surgeon!

To determine costs and estimated surgery times for the procedures Dr. Kaplan performs, click here.

Click here for the original blog post written by Dr. Jonathan Kaplan for BuildMyBod.

“Dr. Kaplan is a true professional. He gave me extremely helpful and direct honest advice…I strongly recommend him.”– David S.

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