Many people may not realize it, but not all surgeries of a given type are the same. Take spays as an example.
Ask a vet which routine surgery they look forward to the least, and I bet that most of them will say adult large dog spays. I've had many of my staff say that they always figured that the big dogs would be easier because the uterus and other organs are bigger and therefore less difficult to find. Quite the contrary, actually. Yes, the diameter of the uterus usually is larger, but so are the intestines. Combine all of those organs with a much larger area to search through and it can be more difficult to find things in a larger dog. Small dog spays are usually quicker and easier.
Additionally you have larger vessels, which means more that you have to tie off and a greater risk for bleeding. Then if you get an adult dog who has had litters in the past those vessels tend to be even bigger. It's actually quite a lot of work and you feel pretty worn out by the time you're done.
Can you guess that I had one of the dogs today? A very sweet yellow lab who was overweight (problem #1), over 70 pounds (problem #2), and had at one point been used for breeding (and there's our hat trick!). From what I was told she had been used in a "puppy mill" and when her breeding days were over she was given away. The current owners realized the risks and mess of an unspayed female, so they brought her in for surgery.
Now I fully commend the owners and think they made the right decision. But once I saw her size and age, I knew I was in for a tough time. All things considered, it was a routine procedure for a dog this big. But it was a lot of work, an extra pack of suture, and more bleeding than I normally have. None of this was concerning or life-threatening, just messy and annoying. It made me long for the 9 pound shih-tzu spay I had done just before her. But she did well, recovered normally, and will heal properly. A good day's work, but one where I really earned the income.
Getting your dog spayed when they are young isn't just good for their health, it's nice for your vet's stress level!