Healthcare News & Insights

The 10 Riskiest Medical Procedures

Anytime a patient is required to — or elects to — have surgery, there are always risks involved. Some surgeries, however, carry with them a higher risk due to the difficulty of the procedure, the importance of the organ and the part of the body being operated on.

Thanks to the skilled medical professionals who perform these surgeries, along with advanced medical technologies, mortality rates and complications have been significantly reduced. But despite ongoing medical advancements, there are still procedures that present high risk for complications during the procedure or recovery period.

Here’s a list of the 10 riskiest medical procedures:

10. Bariatric surgeries/Gastric yypass

bariatric surgery
As with many other major surgeries, there are risks that patients take when electing to undergo them, but these patients’ excessive weight poses even more threats. Surgeons have a harder time operating and must use special instruments because internal organs are often hard to separate and have may layers of slippery fat surrounding them. These patients also have an increased risk for complications with anesthesia, because it’s often difficult to insert the tube into their airways, and drugs or anesthetic gases may need to be given in higher dosages because they are easily absorbed by fat. Breathing must also be closely monitored before, during and after the surgery, as these patients have a higher risk of developing of pneumonia.

9. Septal Myotomy

septal myotomyThis surgical procedure is performed to reduce the thickening of the heart muscles, a symptom of patients diagnosed with advanced stages of a complex type of heart disease called hypertrophic cardiomyopathy (HCM). This is a complicated procedure because it requires the patient to be placed on cardiopulminary bypass, or the “heart-lung machine”, so that the surgeon can work on a still heart. In total, this surgery can last anywhere from 3 to 6 hours, and the recovery period requires a stay in the Intensive Care Unit.

8. Pancreatectomy

pancreatectomy
This procedure comes along with a fairly high risk of complications. In fact, a Johns Hopkins study documented complications in 41% of pancreatectomy cases. These include serious problems like post-operative bleeding, delayed gastric emptying — a condition in which food and liquids are slow to leave the stomach — internal anastomatic leaking. The good news is that in recent years, the mortality rate for this procedure has decreased to a range of 5-10%.

7. Thoracic Aortic Dissection Repair

aortic wallAortic dissection, or a tear in the innermost layer of the heart, can trigger a number of high-risk complications like heart failure, stroke or even a rupture of the aorta, making its repair vital to the survival of the patient. Immediate treatment is required and this often results in the surgeon removing the area of dissected aorta and rebuilding the blood vessel with a synthetic graft.

6. Esophagectomy

esophagusThis is a major surgery which carries a lot of risk because of the reconstruction of the area between the stomach and the healthy part of the esophagus. Three different methods of this surgery can be performed depending on the patient’s condition, but they all carry with them serious risks, such as a leakage of the fluid from the stomach or esophagus where the new connection was made. Despite the risks, most patients recover well and have few complications.

5. Bladder Cystectomy

bladderThis procedure is most often performed to remove a part of, or the entire urinary bladder, in patients diagnosed with bladder cancer. The major risks for this procedure are the highest for an infection of the intestine which can lead to peritonitis or the inflammation of the membrane lining the abdomen. For procedures that remove only a part of the bladder, there is a high risk for urine leakage from the bladder incision site, which can cause a number of other internal problems.

4. Coronary Revascularization

coronary revascularizationAlso known as coronary artery bypass grafting (CABG), this procedure reroutes the blood around one or more clogged coronary arteries to help improve blood flow to the heart. New connections are made using arteries or vein grafts taken from another part of the patient’s body. For some patients whose ventricular function is failing too quickly, this surgery may not be an option because the risks are too high.

3. Spinal Osteomyelitis Surgery

spineThere are a number of treatments that patients may undergo before requiring surgery to correct this spinal infection, but for those with spinal instability, significant deformity and/or neurological deficit, a paravertebral abscess causing sepsis, or any sized epidural abscess, emergency surgery is often needed. Infections of the spine are extremely destructive, and any surgical procedures performed on this area comes with a lot of risk, such as complete or partial paralysis, or other serious infections.

2. Surgical Ventricular Restoration

heart diseaseThis procedure is done to treat congestive heart failure as a result of a heart attack in order to improve its function by restoring it to its normal size and shape. This, like any other heart-related surgery, is very risky because the patient is put on the heart-lung machine and major repairs are done to a very sensitive part of the body. Improvements in techniques have been made and the hospital readmission rate for a SVR is only 8.8%.

1. Craniectomy

craniectomyAny type of brain surgery presents a high risk to the patient because the brain controls every function in the body. But a craniectomy presents even more risks. This procedure requires that the piece of skull removed to access the brain is not replaced after the surgery is complete, leaving fully recovered patients the risk of brain damage after the surgery if they do not properly protect their head. Depending on the area of the brain where this procedure will be performed, other serious risks like changes or loss in the functions of vision, mobility, speech, memory, coordination, and more can be permanent. Excessive build up of fluid in the brain, stroke, seizures, spinal fluid leakage, swelling of the brain, and more can also occur after the procedure, making this one of the highest risk surgeries.

 

Sources: surgery.com
mayoclinic.com
clevelandclinic.org
hopkinsmedicine.org

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