What do surgeons do when they have to go to the bathroom?

September 30, 2025 •

3 min read

With some surgical procedures lasting over 10 hours, a common question arises: What do surgeons do when they have to go to the bathroom? The answer involves a carefully choreographed system of preparation and teamwork designed to prioritize patient safety above all else.

Quick Summary

Surgeons prepare for long procedures by limiting fluid intake. If a break is needed, a colleague takes over while the surgeon "breaks scrub," uses the restroom, and re-scrubs to maintain a sterile environment, ensuring patient safety is always upheld.

Key Points

Teamwork is essential: A surgeon’s bathroom break is possible because a highly-trained surgical team, including assistants and anesthesiologists, can temporarily manage the procedure and patient care.
"Breaking scrub" is standard protocol: When a break is necessary, the surgeon follows a strict process of exiting the sterile field, known as "breaking scrub," and meticulously re-scrubbing upon their return.
Preparation is key: Surgeons and their teams proactively manage their needs for long surgeries by limiting fluid intake and using the restroom before starting.
Patient stability is paramount: No break is taken during a critical stage of the operation. The surgeon first ensures the patient is stable and the surgical site is protected.
Long procedures involve team rotations: For marathon surgeries lasting many hours, shifts of surgical teams may be rotated to ensure everyone stays rested and performs at their best.
Dispelling common myths: The belief that surgeons wear diapers is a widespread myth. Standard, safe procedures involving team support are the reality.

The Meticulous Preparation for Long Surgeries

For any procedure, particularly a long one, preparation is key. Surgical teams, including the lead surgeon, assistants, and nurses, take several pre-emptive steps to manage their personal needs and minimize disruptions. Before the patient is brought into the operating room (OR), the team makes sure to use the restroom, recognizing that once scrubbed in, access is severely restricted. Another common tactic for longer procedures is a conscious, yet careful, reduction of fluid intake before the surgery begins. In marathon surgeries, often scheduled for the most complex cases like organ transplants or separating conjoined twins, breaks are anticipated and planned for, with relief teams prepared to step in.

The Protocols for "Breaking Scrub"

When a surgeon absolutely needs a bathroom break during an operation, they follow a strict protocol known as "breaking scrub". This is a carefully managed process that ensures the sterile environment is never compromised.

The Critical Role of the Surgical Team

The surgical team is crucial for making a surgeon's brief absence possible without jeopardizing the patient. During the primary surgeon's break, one of several qualified individuals takes charge, including assistant surgeons, surgical fellows, or senior residents in teaching hospitals, all capable of maintaining the procedure. The anesthesia team continuously monitors the patient's vital signs, and scrub nurses and technicians maintain the sterile field.

The Step-by-Step Process

The process of a surgeon taking a break is a precise sequence of events: The surgeon informs the team, stabilizes the patient, covers the surgical site, and then "breaks scrub" by removing their sterile gown and gloves to use the restroom. Upon returning, they perform a full surgical scrub and are helped into new sterile attire before resuming the procedure.

Shifting Responsibilities in Marathon Procedures

For exceptionally long operations, exceeding 24 hours, the protocol often involves full team rotations. A fresh, rested surgical team replaces the outgoing one, which can then rest and recuperate. This ensures personal needs are met and maintains peak performance, reducing the risk of error due to fatigue.

Setting the Record Straight on Common Myths

Myth: Surgeons wear diapers during long operations.
Fact: This is a popular misconception. Surgeons do not typically wear diapers. The standard procedure involves team handoffs and planned breaks.
Myth: Surgeons can't take a break under any circumstances.
Fact: The surgical team is structured to support these human needs safely. Short micro-breaks can even benefit surgical performance.

A Comparison of Protocols: Short vs. Long Surgeries


Feature	Short Surgery (e.g., 1-3 hours)	Long Surgery (e.g., 8+ hours)
Break Frequency	Very rare; often can be held until completion.	Breaks are more likely, and sometimes planned in advance as a "comfort stop".
Team Coverage	Assistant surgeons, residents, and the rest of the team maintain stability.	The team maintains the patient, but for very long cases, a dedicated relief surgeon or team may take over.
Fluid Intake	Typically controlled by pre-operative planning.	Must be more carefully managed, with strategic breaks for hydration.
Fatigue Management	N/A	Essential for maintaining performance; team rotations are common.
Break Type	A brief, targeted "scrub out" and "scrub back in."	Can be a planned break or a complete team rotation.

Conclusion: A Symphony of Coordination for Patient Safety

The question of what a surgeon does when they need to use the restroom highlights the immense coordination and rigorous protocol in modern surgery. A managed break is a testament to the comprehensive safety net of the surgical team. Through meticulous pre-operative planning, the established protocol for "breaking scrub," and the support of a highly-trained team, patient safety remains the ultimate priority. This coordinated system ensures that even basic human needs are addressed without compromising the procedure's integrity.

For more information on the intricate work of surgical teams, the American College of Surgeons offers valuable resources on their website.

Frequently Asked Questions

No, this is a popular myth. Surgeons do not typically wear diapers during operations. The surgical team follows specific protocols, including team rotations and managed breaks, to ensure patient safety and address a surgeon's needs.

During a surgeon's break, they will "break scrub" by removing their gown and gloves. An assistant surgeon or a senior resident will take over and monitor the patient and surgical site. The anesthesiologist continues to oversee the patient's vital signs.

Yes, it is completely safe. The surgeon only steps away during a non-critical, stable point in the procedure. A full team of trained professionals remains in the room, and the patient is constantly monitored by the anesthesiologist.

A surgeon must follow a strict protocol to re-enter the sterile field. This involves performing a complete surgical scrub of their hands and arms, then being assisted into a fresh, sterile gown and new sterile gloves by a circulating nurse.

Yes, all members of the surgical team, including nurses and anesthesiologists, are also entitled to breaks. For long procedures, relief staff are brought in to ensure the continuous care and performance of the entire team.

In marathon procedures, like some organ transplants, the surgical teams are often rotated in shifts. A fresh, rested team will take over from the fatigued one to ensure optimal performance and reduce errors.

While surgeons are highly focused during operations and some may try to hold it, particularly for shorter procedures, this isn't sustainable for long hours. They are human, and the safe, established protocol of taking a break is the responsible course of action.