Top 10 Most Dangerous Surgeries

Script written by Cameron Bradford.

Sadly, there are a lot of high-risk medical surgeries. Whether it’s gastric bypass or bariatric surgeries for weight loss, colectomy or bowel resection to treat illnesses like Crohn’s disease or a surgery to separate conjoined twins, these are some of the most complicated medical surgeries in the world. WatchMojo counts down ten of the most high-risk operations you can undergo.

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Script written by Cameron Bradford.

Top 10 Most Dangerous Surgeries

Going under the knife for any reason isn’t fun, but these surgeries are particularly precarious. Welcome to and today, we’re counting down our top picks the top 10 most dangerous surgeries.

For this list, we’re looking at surgeries that are particularly invasive, life threatening or otherwise serious.

#10: Gastric Bypass / Bariatric Surgeries

Gastric bypasses are bariatric surgeries that significantly reduce the capacity of the stomach and/or its ability to absorb food. As such, they are generally done on morbidly obese patients as a way to reduce food consumption and lead to weight loss. The surgery is generally considered a healthy option for morbidly obese people who aren’t able to lose weight in more traditional ways, but of course, there are challenges in such procedures ranging from infection, hemorrhaging, leakage and more. Some studies show as much as a 15% risk in complications, while newer laparoscopic procedures - which involve relatively small incisions and electronic or robotic instruments - brings that risk down to around 7%.

#9: Thoracic Aortic Dissection Repair

Aortic dissection happens when the inner lining of the aorta tears and blood surges through the tear. Aortic dissections can start out slowly and worsen over time and often result in death, so time is of the essence in diagnosing and treating the problem. Typically, aortic dissection most commonly occurs in men aged 60-80, but pregnant women and cocaine users face an elevated risk. However, despite its rareness, its symptoms can be easily mistaken for other maladies. Treatment can involve removing damaged tissue and replacing it with artificial tubing - but this is a dicey undertaking. In the days following surgery, the mortality rate can be from 20% to as high as 30%.

#8: Septal Myectomy

The purpose of the septal myectomy is to clear a better passage for blood by reducing the thickness of the heart’s septal wall. Generally done on patients who suffer from hypertrophic cardiomyopathy, it’s characterized by the heart muscle being obstructively thick, a condition that’s largely under-diagnosed. The danger here comes down to the fact that the surgery involves stopping the heart and using machines that breathe and pump blood for the patient. Despite this, and although there are other treatment options, septal myectomy is usually the most effective treatment type and has success rates in the upper 90s.

#7: Cystectomy

The cystectomy is most commonly used to treat bladder cancer and is now commonly done with robotic instruments for minimal invasiveness. The procedure can see either the whole bladder and lymph structure that surrounds it – called radical cystectomy - or part of these, called partial - removed due to suspected cancer growth. Risks that come with the removal of the bladder result from the surgeon having to disconnect it from all its neighboring structures, including the ureters, urethra, prostate and vas deferens in men or the cervix, ovaries and part of the vagina in women. Once all this is removed, urine flow is rerouted, generally through a stoma. The highly impactful nature of this surgery means a lot could go wrong, with the biggest risks being infections from leaked waste matter and/or infections of the intestine.

#6: Colectomy / Bowel Resection

Much like the cystectomy, the colectomy is generally used to remove cancerous tissue- in this case, parts of the colon in a partial colectomy and all of the large intestine in a total colectomy. A colectomy is also used in cases of diverticulitis, Crohn’s disease and other colon-related maladies. As with any bowel surgery, the primary risks include infection from leaks between joined sections, scar tissue and injury to surrounding organs. Once the affected parts of the colon are removed, the doctors generally have the option to either reconnect the small intestine to the remaining portion of the colon or create a colostomy to make an opening using the large intestine.

#5: Intestine Transplantation

The intestine is one of the more recent frontiers broken in the world of organ transplantation and remains the rarest type of transplant performed. Even after the development of ciclosporin in 1972, which enabled the transplantation of other organs, it was another 16 years before the first successful intestine transplant. Like other transplant surgeries, logistics are some of the biggest challenges; finding and connecting with donors is a perennial hurdle. Generally, the period after the surgery is extremely critical and it usually takes months before the patient is fully recovered. The average first year survival rate is around 70-80% but that number drops to as low as 50% after five years.

#4: Conjoined Twins

The rarity and disparity of conjoined twins makes each case largely unique. Whether the twins are joined by the head, chest, abdomen, hip or elsewhere determines how feasible the surgery is. Frequently, the twins share one or more organs and operating risks death of one or both of them. Even with modern scanning and surgical technology, unexpected roadblocks can come up in surgery. This was the case of Ladan and Laleh Bijani, who were joined at the head, and who, at age 29, sought separation but died when surgeons found an unforeseen blood vessel during the procedure. However, it must be noted that that are instances of success with twins joined at the head, like the pair of Bangladeshi sisters, Trishna and Krishna, who were successfully separated in 2009.

#3: Spinal Osteomyelitis Surgery

Although more common in older people, it is possible but rare for younger patients to get spinal infections from urinary tract infections, organ transplants, compromised immune systems, AIDS, or intravenous drug use. Spinal Osteomyelitis surgery becomes necessary when there’s an infection in the lower spine after bacteria have traveled to the weak parts of a bone. The primary risk involved is in destabilizing the spine, which could cause partial or full paralysis. Once the infected bone is removed during surgery, a bone graft may be implanted.

#2: Surgical Ventricular Restoration [aka Dor Procedure]

In the hours, days and weeks after someone has a heart attack, there are numerous actions taken to restore normal function. Heart attacks can often leave the heart misshapen and can lead to poor pumping function, which may necessitate a surgical ventricular restoration or SVR. The procedure is done by making a small incision in the bottom of the heart and inserting a plastic model that reshapes the heart. Additionally, the surgery is often paired with heart repair operations like coronary artery bypass grafting and valve repair. Around 90% of patients experience improvements after the surgery, but the conditions surrounding the surgeries are generally very dire because a patient is put on a heart-lung machine and we’re dealing with one of the most delicate and important organs of the body.

Before we unveil our top pick, here are a few honorable mentions.
- Coronary Revascularization [aka Coronary Artery Bypass]
- Esophagectomy
- Pancreatectomy

#1: Decompressive Craniectomy

In cases of severe brain trauma when bleeding and swelling pose a critical threat, craniectomies are done to relieve pressure. Given the state of emergency that most craniectomies are done in and the fact that it deals with the brain makes it a high-risk operation from the get-go. Oftentimes, if the patient survives the operation, they’ll come out with minor to severe brain damage, but they can also suffer from bleeding, infection and other brain injuries. Outside of trauma, the craniectomy can also be used to manage major strokes, but the neurosurgical procedure is usually considered a last resort.

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