Do not break up the surgical team! Familiarity and expertise affect operative time in complex surgery - 24/04/18
Abstract |
Background |
The effects of replacing a surgeon's familiar, experienced certified surgical assistant (CSA) on perioperative outcomes in complex surgery were investigated.
Methods |
An interrupted time series of totally laparoscopic pancreatoduodenectomies performed by a single surgeon was retrospectively studied. Segmented regression analysis estimated replacement effects on estimated blood loss (EBL) and operative time.
Results |
The cohort was composed of the last 100 cases with the familiar CSA and the first 100 cases with the replacement CSA. Study groups were similar. Unadjusted segmented regression of operative time and EBL predicted replacement effects of 70 min (95%CI, 18–122; p = 0.008) and 114 cc (95%CI, -93-320; p = 0.3), respectively. Adjusted regression predicted replacement effects of 40 min (95%CI, 0.9–78; p = 0.04) and 27 cc (95%CI, -156-210; p = 0.3).
Conclusions |
The replacement of a familiar, experienced CSA was associated with longer operative times. Despite confinement to a single surgeon and procedure, these results suggest what all surgeons know: excellent help is priceless.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Retrospective study of the replacement of a Certified Surgical Assistant. |
• | Replacement resulted in an initial 40-min increase in operative time per case. |
• | There was no significant effect of the replacement on estimated blood loss. |
Keywords : Familiarity, Surgical assistant, Perioperative outcomes, Teamwork, Laparoscopic pancreatoduodenectomy
Plan
Vol 215 - N° 3
P. 447-449 - mars 2018 Retour au numéro
Article précédent
- Discussion of: Individual surgeon practice is the most important factor influencing diverting ileostomy creation for patients undergoing sigmoid colectomy for diverticulitis
- Discussion of: Do not break up the surgical team! Familiarity and expertise affect operative time in complex surgery
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?