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News

There is an increase in operative time required to complete some surgical procedures

Boston University : 12 April, 2004  (Technical Article)
There is an increase in operative time required to complete some surgical procedures associated with training surgical residents in the operating room, according to an article in the April issue of The Archives of Surgery, one of the JAMA/Archives journals.
According to the article, it is widely believed that the amount of time required to perform an operation increases when the procedure also involves training a surgical resident. The article states that this increase in time does not translate into a financial burden for the hospital. In addition, although not part of this study, other research has shown no deleterious effects of increased operative times.

Timothy J. Babineau, M.D., M.B.A., from Boston University School of Medicine, and colleagues compared the operative times of academic surgeons performing four common surgical procedures before and after the introduction of a post-graduate resident into the operating room at a community teaching hospital. Between January 1, 2001 and June 30, 2002, four academic surgeons performed operations without a resident. During that time, they either operated alone for hernia surgeries, or assisted each other for laproscopic cholecystectomy (gall bladder removal), colectomy (removal of part of the colon), and carotid endarterectomy (removal of plaque from an artery that supplies blood to the brain). From July 1, 2002 through March 31, 2003, these same four surgeons were assisted on the same procedures by a resident physician in the third year of a post-graduate surgical training program.

The researchers found the amount of time required to perform each of the procedures increased with the addition of the surgical resident.

•Hernia surgery – increase of eight minutes
•Laparoscopic cholecystectomy – increase of 23 minutes
•Carotid endarterectomy – increase of 44 minutes
•Partial colectomy – increase of 60 minutes

The authors suggest that time spent in the operating room teaching residents represents an opportunity cost in time that the surgeon could be meeting other demands such as teaching, writing, and research. “Such a cost, however, must be balanced against the time savings that residents generate by unloading many of the preoperative and postoperative patient care tasks that would otherwise fall to the attending staff,” the researchers write.
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