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Impact of Team Familiarity in the Operating Room on Surgical Complications

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The quality of surgical performance depends on the technical skills of the surgical team as well as on non-technical skills, including teamwork. The present study evaluated the impact of familiarity among members of the surgical team on morbidity in patients undergoing elective open abdominal surgery.


A retrospective analysis was performed to compare the surgical outcomes of patients who underwent major abdominal operations between the first month (period I) and the last month (period II) of a 6-month period of continuous teamwork (stable dyads of one senior and one junior surgeon formed every 6 months). Of 117 patients, 59 and 58 patients underwent operations during period I and period II, respectively, between January 2010 and June 2012. Team performance was assessed via questionnaire by specialized work psychologists; in addition, intraoperative sound levels were measured.


The incidence of overall complications was significantly higher in period I than in period II (54.2 vs. 34.5 %; P = 0.041). Postoperative complications grade <3 were significantly more frequently diagnosed in patients who had operations during period I (39.0 vs. 15.5 %; P = 0.007), whereas no between-group differences in grade ≥3 complications were found (15.3 vs. 19.0 %; P = 0.807). Concentration scores from senior surgeons were significantly higher in period II than in period I (P = 0.033). Sound levels during the middle third part of the operations were significantly higher in period I (median above the baseline 8.85 dB [range 4.5–11.3 dB] vs. 7.17 dB [5.24–9.43 dB]; P < 0.001).


Team familiarity improves team performance and reduces morbidity in patients undergoing abdominal surgery.

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This work was supported in part by a grant from the Swiss National Science Foundation (138273).

Conflict of interest

Drs. Anita Kurmann, Sandra Keller, Franziska Tschan-Semmer, Julia Seelandt, Norbert K. Semmer, Daniel Candinas, and Guido Beldi have no conflicts of interest or financial ties to disclose.

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Correspondence to A. Kurmann.

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Mean sound levels above baseline during the first third of the operations showed no significant difference between period I and period II (two-way ANOVA)


Mean sound levels above baseline during the last third of the operations showed no significant difference between period I and period II (two-way ANOVA)

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Kurmann, A., Keller, S., Tschan-Semmer, F. et al. Impact of Team Familiarity in the Operating Room on Surgical Complications. World J Surg 38, 3047–3052 (2014).

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