How long surgeries work?

Lengthy surgeries - how do they work?

Clinical scenario:

A pair of conjoined 4-year-olds who were separated last Tuesday have been off ventilators for 24 hours, and they've opened their eyes. It took a team of surgeons in Hospital Tuanku Jaafar (previously Hospital Seremban) more than a day (28 hrs to be exact) to divide the twins, who shared a body up to the mid-torso. How can surgeons work for so many hours in a row?

The How:

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.

He's not that fierce looking in person, that Dr. K.K.Lim

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 ҜαίخόρЋЯзпїα™ that he stops for food and drink every seven hours or so. He normally drinks Nes-Lo ice or teh-o-ais limau, and chomp down on a few pieces of roti prata. But that's besides the point.
"It really is like a marathon," he said. "You've got to keep hydrated."

There's no sunken eyeballs - signs of dehydration.

When surgeons at the Hospital Tuanku Jaafar Children's Centre 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 Tuanku Jaafar 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.