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Complex Adult Surgery

Three decades of research have consistently demonstrated that patients that have their high-risk surgery at a hospital and by a surgeon that have more experience with the procedure have better outcomes, including lower mortality rates, lower complication rates, and a shorter length of stay than for patients who have their surgery done at a hospital or by a surgeon with less experience.

Based on the research by Dartmouth-Hitchcock Medical Center, Michigan Medicine, and Johns Hopkins Medicine, as well as guidance from Leapfrog’s national expert panel, Leapfrog has identified eight high-risk procedures for which there is a strong volume-outcome relationship.

The procedures with their corresponding minimum hospital volumes and minimum surgeon volumes for privileging are shown in the table below.

Procedure Minimum hospital volume standard Minimum surgeon volume standard
Bariatric surgery for weight loss 50 20
Esophageal resection for cancer 20 7
Lung resection for cancer 40 15
Pancreatic resection for cancer 20 10
Rectal cancer surgery 16 6
Carotid endarterectomy 20 10
Mitral valve repair and replacement 40 20