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Do surgeons wear diapers?
February 7, 2007 7:45 PM   Subscribe

How do surgeons satisfy various bodily requirements during marathon surgeries? There's

During those marathon 20 hour surgeries (think seperation of conjoined twins, multi-orgen transplants, etc...) how do surgeons take care of various requirements such as urination and eating? I can't imagine they'd go that entire time without food and wear a diaper or something but I also can't imagine them stepping out for a break.

I know there's some surgery related professionals out there who could explain!
posted by Octoparrot to Health & Fitness (11 answers total) 2 users marked this as a favorite
 
There usually a team of surgeons with big surgeries like this. I imagine they would take a break and scrub back in.
posted by LoriFLA at 7:59 PM on February 7, 2007


I guess shifts.
posted by magikker at 8:00 PM on February 7, 2007


Shifts is correct. Each surgeon will take a break at certain points in the surgery where either they are not involved or another team member can do the current task.
posted by JohnnyGunn at 8:07 PM on February 7, 2007


I work in surgery. Disclaimer, in my over ten years as a R.N. in surgery, I have not been in a 20 hr case. However, I have been in many 8-10 hr. cases. They usually do not break to go to the bathroom or for a drink. This is part of their training, (not drinking a lot of fluids prior to surgery). I have had to go get a drink with a straw to bring to the doctor as he steps away from the field to sip it, being extremely careful to not contaminate. This is only at their request and it's not the norm, (think--surgery is going longer than they expected, or they are at a crucial point). On many cases, especially longer cases, there is an assistant surgeon. If they have to step out, there is still the assistant surgeon.

When you read about the conjoined twins, etc., these cases are done at a teaching facility. From what I have read, there are *shifts* involved. With teaching facilities, there is always an attending surgeon, (with residents, fellows, etc.).
posted by 6:1 at 8:15 PM on February 7, 2007


Teams is right. Here's an article from slate specifically on marathon surgeries.
posted by jourman2 at 8:20 PM on February 7, 2007


I knew a liver transplant doc who wore a Foley catheter during long operations. Most of the other surgeons in that medical center thought that was crazy, though. You can always scrub out and back in quickly.
posted by ikkyu2 at 10:03 PM on February 7, 2007


Also, a lot of surgeons don't drink fluids until they're done with cases for the day, too.
posted by gramcracker at 11:11 PM on February 7, 2007


I have done the anesthesia on a couple of 23 hour surgeries (including this guy's) and there are a number of strategies surgeons use during these cases. Sometimes there are teams of surgeons; in one case I was in the ENT surgeons spent about 12 hours doing a radical cancer surgery on a patient and then they left and the plastic surgeons spent 12 hours doing a complicated reconstruction. In other cases, there is only one attending surgeon (usually when it is a highly specialized procedure that few surgeons are familiar with), but even then they do not work alone. For a larger operation there will be one or more assistants and/or surgeons in training (residents or fellows) and these people, who may be fully qualified surgeons in their own right, will do the more mundane parts of the procedure like opening and closing the skin while the attending surgeon of record only comes in for the more complex parts of the operation. It is not at all unusual for surgeons to break scrub and leave the room, even during shorter operations. For example, if a surgeon suddenly need to use the bathroom, it would be better for him to get that done and come back, rather than be distracted while trying to operate. More commonly, a surgeon will leave to do something like go over a specimen with the pathologist to ensure that he has gotten all of a tumor or gotten tissue that is adequate for diagnosis. This in no way means the patient is left unattended, however. There is always a qualified anesthesia provider with the patient, who is responsible for monitoring vital signs and intervening as needed to keep them stable (I phrase it as "while the surgeon is doing his job, we look after the rest of the patient") as well as OR nurses and the aforementioned surgical assistants.

Also as mentioned above surgeons drink as little as possible during long cases; this is why, like school teachers, surgeons are at some increased risk for kidney problems. Eating is less of a problem, and most surgeons will not have a problem going all day (and night if needed) without food. On the other hand, I used to work with one surgeon who made it a point to break scrub in the middle of almost every case to drink some sort of special energy concoction he brought with him. This was always during a part of the case where there was some testing going on and he would have been just standing around anyway, so it really didn't affect the routine of the OR.

I, too have heard stories of catheters and diapers, but haven't actually seen a surgeon use one (then again, I have only been doing anesthesia since 1989).

I think most people that haven't worked in an OR have a very different view of what goes on there than what really happens. It tends to be much less formal and more loosely structured than what is often portrayed in movies an on TV. This is good, otherwise it would be impossible for anyone but the most anal people to work there for any length of time.
posted by TedW at 6:14 AM on February 8, 2007 [1 favorite]


I just looked at the Slate article linked above and while it was pretty good, it doesn't tell the whole story. It focused on conjoined twin surgery, which is a whole different animal, as it involves two patients in one operating room. That means in addition to the teams of surgeons there are two teams of nurses and assistants at all times as well as two anesthesia machines, two operating tables, two instrument tables, and so on, all crammed into an operating room designed for one patient at a time. The logistics of those procedures can be quite daunting and that is part of why so few hospitals perform them (as well as the fact that conjoined twins are pretty uncommon). I have never been involved in one, but my boss has.
posted by TedW at 6:22 AM on February 8, 2007


I used to work for a consultant general surgeon who once a week did a Whipple's procedure, often taking up the whole operating list between 8am and 4.30pm. He was a tough b******, and it was a point of pride that he would never pee, drink, or descrub for any reason during the procedure. All the juniors would be allowed to leave theatre one at a time for 10 minutes to grab a sandwich and pee around lunchtime though.
posted by roofus at 2:27 AM on February 9, 2007


Maybe Joe would know?
posted by TheAnswer at 1:28 PM on February 9, 2007


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