How do surgeons work for 26 hours straight?

Answers to your questions about the news.
Aug. 14 2006 6:11 PM

Twenty-Six Hours in Surgery?

How long operations work.

Richard Holbrooke, the president's envoy to Pakistan and Afghanistan, underwent more than 20 hours of surgery to repair a torn aorta over the weekend. In an "Explainer" column reprinted below, Daniel Engber told how surgeons keep at it for such long periods of time.

A pair of conjoined 4-year-olds who were separated in mid-August have moved out of the intensive-care unit. It took a team of surgeons in Utah more than a day to divide the twins, who shared a body up to the mid-torso. How can surgeons work for so many hours in a row?

They work in teams. A conjoined-twin operation can be broken down into many stages, like the initial incision, the work around the bones, separation of the blood vessels, and reconstructive plastic surgery. A different team of surgeons scrubs into the operating room for each stage, most of which take only a few hours to complete. That way, most of the surgeons don't end up working for more than four or five hours in a row.

Daniel Engber Daniel Engber

Daniel Engber is a columnist for Slate

The lead surgeons try to stay involved for the duration. They'll stay in the operating room for as long as they can, with a couple of breaks for snacks and rest. A surgeon who specializes in long-haul surgeries told the Denver Post that he stops for food and drink every seven hours or so. "It really is like a marathon," he said. "You've got to keep hydrated."

When surgeons at the Johns Hopkins Children's Center separated a pair of twins who were conjoined at the head, they had a live feed of the procedure on a video display in a room upstairs. That way doctors who weren't involved in a particular stage could scrub out for a while and watch the operation on TV.

For the Hopkins conjoined-twin procedure, four surgeons operated at any one time, with one pair assigned to each twin. Nurses shifted into the procedure every few hours, with two assigned to each pair of surgeons. Having so many people at the table could get a little confusing, so nurses and surgeons who worked together wore the same color stripe on their surgical caps.

Got a question about today's news? Ask the Explainer.

Explainer thanks George Jallo of the Johns Hopkins Children's Center.



The Democrats’ War at Home

How can the president’s party defend itself from the president’s foreign policy blunders?

Why Time Is on Our Side in the Fight Against Ebola

Piper Kerman on Why She Dressed Like a Hitchcock Heroine for Her Prison Sentencing

Catacombs Where You Can Stroll Down Hallways Lined With Corpses

Homeland Is Good Again! For Now.


Cringing. Ducking. Mumbling.

How GOP candidates react whenever someone brings up reproductive rights or gay marriage.


How Even an Old Hipster Can Age Gracefully

On their new albums, Leonard Cohen, Robert Plant, and Loudon Wainwright III show three ways.

The U.S. Has a New Problem in Syria: The Moderate Rebels Feel Like We’ve Betrayed Them

We Need to Talk: A Terrible Name for a Good Sports Show by and About Women

Trending News Channel
Oct. 1 2014 1:25 PM Japanese Cheerleader Robots Balance and Roll Around on Balls
  News & Politics
Oct. 1 2014 4:15 PM The Trials of White Boy Rick A Detroit crime legend, the FBI, and the ugliness of the war on drugs.
Oct. 1 2014 2:16 PM Wall Street Tackles Chat Services, Shies Away From Diversity Issues 
Gentleman Scholar
Oct. 1 2014 4:55 PM Blood Before Bud? Must a gentleman’s brother always be the best man at his wedding?
  Double X
The XX Factor
Oct. 1 2014 5:11 PM Celebrity Feminist Identification Has Reached Peak Meaninglessness
  Slate Plus
Behind the Scenes
Oct. 1 2014 3:24 PM Revelry (and Business) at Mohonk Photos and highlights from Slate’s annual retreat.
Brow Beat
Oct. 1 2014 3:02 PM The Best Show of the Summer Is Getting a Second Season
Future Tense
Oct. 1 2014 4:46 PM Ebola Is No Measles. That’s a Good Thing. Comparing this virus to scourges of the past gives us hope that we can slow it down.
  Health & Science
Oct. 1 2014 4:03 PM Does the Earth Really Have a “Hum”? Yes, but probably not the one you’re thinking.
Sports Nut
Oct. 1 2014 5:19 PM Bunt-a-Palooza! How bad was the Kansas City Royals’ bunt-all-the-time strategy in the American League wild-card game?