Abstract
Background
Performing laparoscopic procedures requires different skill sets and team dynamics compared with open procedures. We evaluated team composition and procedure time between these two surgical approaches using data collected from hospitals in the United State and Canada.
Methods
A total of 1,260 general surgical cases were reviewed retrospectively, recording the number of operation personnel, procedure complexity, and the procedure time.
Results
Laparoscopic procedures (n = 930), on average, had a higher procedure difficulty coding which led to a longer procedure time and involved more people in the surgical team than open procedures (n = 330). When we selected cases with matched procedure difficulty coding, laparoscopic procedures (n = 450) still required longer procedure times and involved more operative personnel than open procedures (n = 92).
Discussion
Increased laparoscopic team size and procedure time must be influenced by factors other than case difficulty. The factors may derive from inherent complexity of the surgical setting and team dynamics unique to laparoscopic procedures.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Catchpole K, Mishra A, Handa A, McCulloch P (2008) Teamwork and error in the operating room: analysis of skills and roles. Ann Surg 247:699–706
Park J, Woodrow SI, Reznick RK, Beales J, MacRae HM (2007) Patient care is a collective responsibility: perceptions of professional responsibility in surgery. Surgery 142:111–118
Sexton JB, Makary MA, Tersigni AR, Pryor D, Hendrich A, Thomas EJ, Holzmueller CG, Knight AP, Wu Y, Pronovost PJ (2006) Teamwork in the operating room: frontline perspectives among hospitals and operating room personnel. Anesthesiology 105:877–884
Cassera MA, Zheng B, Martinec DV, Dunst CM, Swanstrom LL (2009) Surgical time independently affected by surgical team size. Am J Surg 198:216–222
Zheng B, Panton ON, Al-Tayeb TA (2012) Operative length independently affected by surgical team size: data from 2 Canadian hospitals. Can J Surg 55:371–376
Zheng B, Taylor MD, Swanstrom LL (2009) An observational study of surgery-related activities between nurses and surgeons during laparoscopic surgery. Am J Surg 197:497–502
Berguer R, Forkey DL, Smith WD (1999) Ergonomic problems associated with laparoscopic surgery. Surg Endosc 13:466–468
Lee EC, Rafiq A, Merrell R, Ackerman R, Dennerlein JT (2005) Ergonomics and human factors in endoscopic surgery: a comparison of manual vs telerobotic simulation systems. Surg Endosc 19:1064–1070
van Det MJ, Meijerink WJ, Hoff C, Totte ER, Pierie JP (2009) Optimal ergonomics for laparoscopic surgery in minimally invasive surgery suites: a review and guidelines. Surg Endosc 23:1279–1285
Fried M, Krska Z, Danzig V (2001) Does the laparoscopic approach significantly affect cardiac functions in laparoscopic surgery? Pilot study in non-obese and morbidly obese patients. Obes Surg 11:293–296
Tsereteli Z, Terry ML, Bowers SP, Spivak H, Archer SB, Galloway KD, Hunter JG (2002) Prospective randomized clinical trial comparing nitrous oxide and carbon dioxide pneumoperitoneum for laparoscopic surgery. J Am Coll Surg 195:173–179; discussion 179–180
Buzink SN, Botden SBI, Heemskerk J, Goossens RM, Ridder H, Jakimowicz J (2009) Camera navigation and tissue manipulation; are these laparoscopic skills related? Surg Endosc 23:750–757
Chmarra MK, Kolkman W, Jansen FW, Grimbergen CA, Dankelman J (2007) The influence of experience and camera holding on laparoscopic instrument movements measured with the TrEndo tracking system. Surg Endosc 21:2069–2075
Zheng B, Martinec DV, Cassera MA, Swanstrom LL (2008) A quantitative study of disruption in the operating room during laparoscopic antireflux surgery. Surg Endosc 22:2171–2177
Kelley JE, Burrus RG, Burns RP, Graham LD, Chandler KE (1993) Safety, efficacy, cost, and morbidity of laparoscopic versus open cholecystectomy: a prospective analysis of 228 consecutive patients. Am Surg 59:23–27
Sándor J, Lengyel B, Haidegger T, Saftics G, Papp G, Nagy Á, Wéber G (2010) Minimally invasive surgical technologies: challenges in education and training. Asian J Endosc Surg 3:101–108
Martinec DV, Gatta P, Zheng B, Denk PM, Swanstrom LL (2009) The trade-off between flexibility and maneuverability: task performance with articulating laparoscopic instruments. Surg Endosc 23:2697–2701
Kenyon TA, Lenker MP, Bax TW, Swanstrom LL (1997) Cost and benefit of the trained laparoscopic team. A comparative study of a designated nursing team vs a nontrained team. Surg Endosc 11:812–814
McCallin AM (2006) Interdisciplinary researching: exploring the opportunities and risks of working together. Nurs Health Sci 8:88–94
Birch DW, Sample C, Gupta R (2007) The impact of a comprehensive course in advanced minimal access surgery on surgeon practice. Can J Surg 50:9–12
Aggarwal R, Crochet P, Dias A, Misra A, Ziprin P, Darzi A (2009) Development of a virtual reality training curriculum for laparoscopic cholecystectomy. Br J Surg 96:1086–1093
Powell SM, Hill RK (2006) My copilot is a nurse—using crew resource management in the OR. AORN J 83:179–183
Disclosures
Bin Zheng, Eric Fung, Lee Swanström, Neely Panton and Bo Fu have no conflicts of interest or financial ties to disclose.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zheng, B., Fung, E., Fu, B. et al. Surgical team composition differs between laparoscopic and open procedures. Surg Endosc 29, 2260–2265 (2015). https://doi.org/10.1007/s00464-014-3938-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-014-3938-3