Standardization in surgeries ensures patient safety and improves outcomes. Advances in medicine have largely optimized surgical spaces and created advanced machinery to monitor vitals. One of the most significant sources of variability that still remains in surgical cases is the technique and experience of individual surgeons, which can impact many aspects of the procedure. In particular, surgeon speed has implications for anesthesia care, scheduling, and finances, and anesthesiologists must be able to adapt to variation in it to ensure patient safety, effective case management, and operating room (OR) efficiency.

Variation in surgeon speed is due to a combination of intrinsic and extrinsic factors. Perhaps the most notable variable is the amount of experience and training a surgeon has. More experienced surgeons are typically more efficient, having refined their technique, communication style, and decision-making process through the lived experiences of prior cases. Through their extensive practice, experienced surgeons may also have improved dexterity and the ability to anticipate intraoperative challenges, potentially leading to better health outcomes; however, outcomes are also impacted by the site of care (1). Nonetheless, for more complex, unfamiliar procedures, surgeons must take their time to ensure safe and effective care is delivered.

Regardless of experience, surgeon speed is also impacted by the efficiency of the OR staff. This includes surgical assistants, scrub nurses, and anesthesiologists, who all must be in coordination with each other to facilitate a smooth surgical flow. Without good team coordination, surgeries may take longer to perform (2).

The ability of a team to perform efficiently at a high level may be further slowed by institutional or environmental factors, such as variation in hospital protocols and the availability of appropriate medical devices and instruments. A hospital that lacks the necessary resources to perform a swift, safe, and effective procedure in compliance with the latest guidelines will further hinder the surgeon’s speed through possible delays in surgery (3).

Variation in surgeon speed can also be due to the type of procedure being performed. It is important to take the complex nature of the procedure into account when estimating how quickly or slowly the surgeon can complete it. For example, a straightforward laparoscopic cholecystectomy should be significantly faster than a complex oncologic resection (4).

Furthermore, the perioperative team must consider various patient-specific factors which may increase the complexity and duration of surgery. This may include a patient’s BMI, comorbidities such as diabetes and hypertension, as well as other anatomical variations that could impact care. These complexities may also affect anesthetic care, requiring additional vigilant monitoring to avoid complications (5).

While surgeon speed is an independent factor, anesthesiologists can help optimize workflow through several strategies, including preoperative communication, real-time intraoperative adjustments, and more generally by collaborating with the OR staff to ensure instrument readiness and OR turnover.

Variation in individual surgeon speed is an unavoidable reality in surgical care. Understanding these differences and implementing strategies to optimize workflow through both team and supply preparedness can enhance patient outcomes, improve efficiency, and minimize complications. Although variations will exist depending on a surgeon’s prior experiences, an adaptable approach ensures that all surgeons work within a system that prioritizes safety, effectiveness, and resource management.

References

1. Kelz, R. R., Sellers, M. M., Niknam, B. A., Sharpe, J. E., Rosenbaum, P. R., Hill, A. S., Zhou, H., Hochman, L. L., Bilimoria, K. Y., Itani, K., Romano, P. S., & Silber, J. H. (2019). A national comparison of operative outcomes of new and experienced surgeons. Annals of Surgery, 273(2), 280–288. https://doi.org/10.1097/sla.0000000000003388
2. Osborne-Smith, L., & Hodgen, R. K. (2016). Communication in the operating room setting. Annual Review of Nursing Research, 35(1), 55–69. https://doi.org/10.1891/0739-6686.35.55
3. Wubben, I., Van Manen, J. G., Van Den Akker, B. J., Vaartjes, S. R., & Van Harten, W. H. (2010). Equipment-related incidents in the operating room: an analysis of occurrence, underlying causes and consequences for the clinical process. BMJ Quality & Safety, 19(6), e64. https://doi.org/10.1136/qshc.2009.037515
4. Crespin, D. J., Ruder, T., Mulcahy, A. W., & Mehrotra, A. (2022). Variation in estimated surgical procedure times across patient characteristics and surgeon specialty. JAMA Surgery, 157(5), e220099. https://doi.org/10.1001/jamasurg.2022.0099
5. Seyni-Boureima, R., Zhang, Z., Antoine, M. M., & Antoine-Frank, C. D. (2022). A review on the anesthetic management of obese patients undergoing surgery. BMC Anesthesiology, 22(1). https://doi.org/10.1186/s12871-022-01579-8

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