Skip to main content

Complex Adult and Pediatric 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 eleven 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.

ProcedureAnnual hospital volume stanardAnnual surgeon volume standard
Bariatric surgery for weight loss5020
Esophageal resection for cancer207
Lung resection for cancer4015
Pancreatic resection for cancer2010
Rectal cancer surgery166
Carotid endarterectomy2010
Open aortic procedure107
Mitral valve repair and replacement4020
Total knee replacement surgery5025
Total hip replacement surgery5025
Congenital heart surgery for infants (Norwood procedure)85