There’s currently a debate in the medical industry regarding the safety of concurrent surgeries—multiple surgical procedures that are performed at the same time in separate operating rooms with one main, overseeing surgeon that travels back and forth between the different patients as it’s safe to do so. For years, doctors and hospitals have argued that concurrent surgeries, often referred to as double-booked surgeries, are safe. Now a new major hip operation study is suggesting differently.
The study looked at over 90,0000 orthopedic hip surgeries at 75 hospitals in Ontario, Canada. It was discovered that the longer the duration of overlap between surgeries, the more likely patients were to suffer from complications within a year after the procedure. These complications included infections and the need for a second surgery.
Researchers found that the complication rate for patients undergoing hip replacement surgery or surgery for hip fractures rose 80-90% if a surgeon was overseeing two operations for as little as 30 minutes. To be exact, the risk of complications rose 7% for every 10 minutes of overlap. Most hip surgeries overlapped for 30 to 60 minutes, the researchers found, but many overlapped for periods as long as 3 hours.
The overall rate of complications remained relatively rare for patients with normal procedures and overlapped procedures, but the increase in rate itself is significant. For patients undergoing hip replacement surgery, the risk of complication increased from 1.4% to 2.3% while the risk of complication for hip fracture surgery patients increased from 6.4% to 10.4%.
These increased rates are significant—and worth discussing. It’s also worth noting that this study is the first of its kind that examined records from major hospitals that operated on tens of thousands of patients. Previous studies only examined records from select, smaller hospitals.
This study also examined patient outcomes up to a year after the procedures. Most previous studies stopped at a few weeks afterwards which gave the researchers a very limited window regarding potential infection symptoms and long-term recovery complications.
Why Are Double-Booked Surgeries Performed?
By performing multiple operations at the same time, a hospital can complete more surgeries while paying a single, overseeing surgeon. Both operating rooms still employ a full staff of assistant surgeons and team members, of course, but with only one overseeing surgeon, this reduces costs significantly. As the overseeing surgeon travels to the other operating room, the assistant surgeons will take over and may even use the extra time to teach newer doctors.
Potential issues arise, however, since both patients are under anesthesia for a longer period and are exposed to potential environmental elements for an extended time. Many major surgeries—including orthopedic surgeries—can last for 3 hours or longer. Extending that period of exposure only increases the risk of infection.
The worst part about concurrent surguries might be the fact that most patients do not know their surgeons are performing multiple operations at the same time they’re being operated on. According to a team report conducted by The Boston Globe, many surgeons are encouraged to let their patients know that they will be operating on other patients during their procedures, but many opt out of informing their patients altogether.
Different hospitals have different policies regarding double-booked surgeries, how often they’re performed, and for what procedures. Some of the most prestigious hospitals allow it because their surgeons are highly sought-after and perform some of the most complex and needed surgeries in the nation. Others are beginning to realize that there are very real potential dangers involved in letting patients be subjected to extra time under anesthesia.
These potential dangers have been becoming apparent in the form of multiple medical malpractice lawsuits that are currently pending. At least two major lawsuits have been filed against Massachusetts General Hospital for concurrent surgeries that that were performed and resulted in devastating consequences for patients. The lawsuits allege that the hospital performed simultaneous operations for the sake of profit and placed patient lives at risk as a result.