'Dual operating' – an old innovation

Petri, GJ; T, Banerjee

doi:10.1308/147363506x110157

Cited by 4 publications

(4 citation statements)

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“…The median waiting time to subsequent symmetrization was 14 months in the study institution, which is a considerable amount of time for many women experiencing the psychological morbidity of asymmetry. Surgical waiting lists are usually explained by a ‘lack of resources’ or, more specifically, a ‘lack of surgeons’ 23 ; however, it is hoped that the approach described here demonstrates how a radical review of theatre practices and surgeon collaboration may optimize operating theatre time, improve surgical efficiency, and significantly reduce the number of patients on waiting lists for symmetrization surgery. The latter is critical in the era of the COVID-19 pandemic when providers are desperately seeking to streamline resources, optimize patient care, and reduce contact points or number of treatments in the hope of reducing transmission.…”

Section: Discussionmentioning

confidence: 99%

“…One solution is to offer a synchronous two-consultant team approach with the goal of facilitating immediate symmetrization, reducing operating time 21 , 22 , maximizing list utilization 23 , and theoretically reducing costs 24 associated with the second hospital episode in a staged mammoplasty approach. A dual-operator approach is postulated to confer better control of the operative field, intraoperative recognition of technical errors, and better assistance for the primary surgeon, rendering a technically complex operation more straightforward 25 , but to date the approach has not been extrapolated to BCS.…”

Section: Introductionmentioning

confidence: 99%

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Patient-level costs of staged unilateral versus immediate bilateral symmetrization mammoplasty in breast-conserving surgery

et al. 2022

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Background Following therapeutic mammoplasty (TM), the contralateral breast may require a later balancing procedure to optimize shape and symmetry. The alternative is to offer patients simultaneous TM with immediate contralateral symmetrization via a dual-surgeon approach, with the goal of reducing costs and minimizing the number of subsequent hospital appointments in an era of COVID-19 surges. The aim of this cost–consequence analysis is to characterize the cost–benefit of immediate bilateral symmetrization dual-operator mammoplasty versus staged unilateral single operator for breast cancer surgery. Method A prospective single-centre observational study was conducted at an academic teaching centre for breast cancer surgery in the UK. Pseudonymized data for clinicopathological variables and procedural care information, including the type of initial breast-conserving surgery and subsequent reoperation(s), were extracted from the electronic patient record. Financial data were retrieved using the Patient-Level Information and Costing Systems. Results Between April 2014 and March 2020, 232 women received either immediate bilateral (n = 44), staged unilateral (n = 57) for breast cancer, or unilateral mammoplasty alone (n = 131). The median (interquartile range (i.q.r.)) additional cost of unilateral mammoplasty with staged versus immediate bilateral mammoplasty was €5500 (€4330 to €6570) per patient (P < 0.001), which represents a total supplementary financial burden of €313 462 to the study institution. There was no significant difference between groups in age, Charlson comorbidity index, operating minutes, time to adjuvant radiotherapy in months, or duration of hospital stay. Conclusion Synchronous dual-surgeon immediate bilateral TM can deliver safe immediate symmetrization and is financially beneficial, without delay to receipt of adjuvant therapy, or additional postoperative morbidity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patient-level costs of staged unilateral versus immediate bilateral symmetrization mammoplasty in breast-conserving surgery

et al. 2022

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“…An audit assessing the efficiency of dual surgeon operating versus conventional single surgeon structure for orthopaedics, demonstrated a significantly higher number of overall cases completed by the dual surgeon team, across 50 consecutive 3.5 h lists. 28 The dual surgeon team completed 270 cases overall, of which 75 were classified as major and complex. The conventional single surgeon cohort only completed 102 cases in the same time frame, of which only 35 were defined as major or complex.…”

Section: Challengesmentioning

confidence: 99%

“…The conventional single surgeon cohort only completed 102 cases in the same time frame, of which only 35 were defined as major or complex. 28 However, more research is needed within the field of general surgery to compare the impact of dual surgeon operating on productivity measures.…”

Section: Challengesmentioning

confidence: 99%

Do we need a co-pilot in the operating theatre? A cross-sectional study on surgeons’ perceptions

Taribagil,

Liu,

Bhattacharya

et al. 2023

Scott Med J

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Objective The aim of this original study was to investigate general surgeons’ perceptions on the role of dual surgeon operating for high-risk, elective complex surgical procedures. Material and Methods A 21-part cross-sectional online survey was self-completed by 85 general surgeons across hospitals in the UK. The survey assessed the perception of dual surgeon operating on patient morbidity and mortality, surgeons’ burnout rates, complaints, patient waiting times and overall trainee experience. Statistical analysis was performed using R version 3.6.1. Results Overall 78.8% believed that dual surgeon operating could help to overcome these human factors. Sub-analysis includes improve surgeon fatigue (89.4%), improve confidence (83.5%), improve decision-making (76.5%), minimise technical error (69.4%), improve communication, team work and leadership skills (65.9%). 65.9% believed it would reduce surgeons’ burnout. There was a statistically significant relationship between the participants believing it would reduce surgeons’ burnout and those who felt it would reduce complaints, Chi-squared(4) = [30.8], p = [0.00000342]. A statistically significant relationship was noted between participants believing it would reduce surgeons’ burnout and those who felt it would reduce patient mortality/morbidity, Chi-squared(4) = [19.9], p = [0.000517]. Conclusion The survey has highlighted positive surgeons’ perceptions regarding dual surgeon operating.

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Trauma theatre productivity – Does the individual surgeon, anaesthetist or consultant presence matter?

Turnbull

Hakimi

McLauchlan

2018

Injury

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'Dual operating' – an old innovation

Cited by 4 publications

References 0 publications

Patient-level costs of staged unilateral versus immediate bilateral symmetrization mammoplasty in breast-conserving surgery

Patient-level costs of staged unilateral versus immediate bilateral symmetrization mammoplasty in breast-conserving surgery

Do we need a co-pilot in the operating theatre? A cross-sectional study on surgeons’ perceptions

Trauma theatre productivity – Does the individual surgeon, anaesthetist or consultant presence matter?

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