What is the typical duration of a Modified Radical Mastectomy (MRM) surgery in hours?

Duration of Modified Radical Mastectomy Surgery

Modified radical mastectomy (MRM) typically takes 1.5-2 hours to complete, with an average operative time of approximately 105-120 minutes. 1, 2

Factors Affecting Surgery Duration

The duration of MRM can vary based on several factors:

1. Surgical technique and equipment used:

   • Traditional methods using scalpel and electrocautery: ~120 minutes 2
   • Harmonic scalpel technique: ~117 minutes 2
   • Electrothermal bipolar vessel sealing system: ~105 minutes 1

2. Patient-specific factors:

   • Breast size
   • Body habitus
   • Previous surgeries
   • Extent of disease

3. Surgical complexity:

   • Level of axillary dissection required
   • Need for additional procedures
   • Intraoperative findings

Operative Steps and Time Allocation

MRM involves several key steps that contribute to the overall duration:

• Skin incision and flap creation: 20-30 minutes
• Breast tissue removal: 20-30 minutes
• Axillary lymph node dissection: 30-45 minutes
• Hemostasis and closure: 20-30 minutes

Perioperative Considerations

Preoperative

• Patient preparation and anesthesia induction: 30-45 minutes (not included in operative time)

Postoperative

• Recovery from anesthesia: 1-2 hours
• Most patients can be discharged within 24 hours 3, 4
• Some centers now perform MRM as outpatient procedures 4

Complications Affecting Duration

Intraoperative complications may extend the duration of surgery:

• Excessive bleeding: Mean blood loss ranges from 45-60 mL with modern techniques 1, 2
• Anatomical variations
• Technical difficulties during axillary dissection

Modern Trends

Recent advances have led to shorter operative times:

• Use of specialized equipment like the electrothermal bipolar vessel sealing system has reduced operative time to approximately 105 minutes 1
• Harmonic scalpel techniques average around 117 minutes 2
• Improved surgical techniques and experience have streamlined the procedure

Hospital Stay

While not directly related to operative time, hospital stay has significantly decreased:

• Traditional hospital stays of 5-7 days have been reduced to 1-3 days 3
• Many centers now perform MRM as outpatient procedures or with 23-hour observation 4
• Mean hospital stay with modern techniques is approximately 3.7 days 1

The adoption of newer surgical technologies and techniques has not only improved operative times but also reduced complications such as blood loss, drainage volume, and hospital stay, contributing to better overall outcomes for patients undergoing MRM.