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Classification for Complexity of Surgical Procedure

Purpose: To classify a surgical procedure based on its operative complexity using the scheme of Cohen et al.

Description

Cohen et al classified surgical procedures based on the operative complexity. The authors are from the University of Manitoba and University of Saskatchewan in Canada.


Complexity categories:

(1) major

(2) intermediate

(3) minor

 

Type of Operation

Complexity

intracranial

major

major vascular

major

intra-thoracic

major

intra-abdominal

intermediate

limb

intermediate

trunk

intermediate

spine

intermediate

head and neck (not major or minor)

intermediate

eye

minor

ear, nose, throat (ENT)

minor

perineal

minor

endoscopy

minor

 

Modifications:

• Minimally invasive surgery was not available at the time. One way to incorporate this would be to reduce the complexity rating by one level.

• Organ transplant surgery would qualify from major (heart-lung) to intermediate (renal).

 

In the paper's analysis of risk for mortality in the week following surgery, the odds ratio for intermediate surgery was 1.8 and for major surgery was 3.8 relative to minor surgery.


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Specialty

Objective

ICD-10