Expert consensus for key components of a high-quality ventral hernia repair operative note

IF 2.7 2区 医学 Q1 SURGERY Surgery Pub Date : 2025-02-12 DOI:10.1016/j.surg.2025.109169
Jonathan S. Lall BS , Said Maldonado BS , Nicole B. Lyons MD , Gina Adrales MD , Karla Bernardi MD , Anne P. Ehlers MD, MPH , Hobart Harris MD , Julie Holihan MD , William Hope MD , Jeffrey E. Janis MD , Michele Loor MD , Clayton Petro MD , Luke Putnam MD , Caroline E. Reinke MD , John Scott Roth MD , Christopher Senkowski MD , Kendell Sowards MD , Shirin Towfigh MD , Daniel Dante Yeh MD, MPHE , Zuhair Ali MD , Mike K. Liang MD
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Abstract

Background

Ventral hernia repair (VHR) is one of the most commonly performed procedures by surgeons; however, there remains a lack of consensus for key components of operative reporting. Prior literature has identified several key elements that are recommended for inclusion in ventral hernia repair operative notes, but it is unclear whether these details alone make for a high-quality operative note. This study sought to determine whether experts agree on what factors make a ventral hernia repair operative note high-quality.

Study Design

A prospective exploratory sequential survey-based mixed-methods design was used for round 1. Conclusions via thematic analysis from survey responses were used to establish themes/subthemes to be included in a high-quality ventral hernia repair operative note. Round 2 used a convergent design and sought to evaluate the importance of these identified themes/subthemes.

Results

Twenty-four surgeons were approached, 16 of whom completed both rounds. Nine themes and 3 subthemes were identified as essential for inclusion in a high-quality ventral hernia repair operative note. Round 2 determined that the 5 most important themes to include are accurate/adequate/pertinent details, clarity in writing, detailed/specific/comprehensive information, objective reporting of findings and procedures, and justification/rationale for decisions.

Conclusion

Based on expert consensus, this study suggests that high-quality operative notes require more than just detailed information. Instead, they must incorporate qualities spanning the 9 identified themes to ensure clarity, comprehensiveness, and effectiveness.

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专家共识:高质量腹股沟疝修补术手术记录的关键要素
背景腹疝修补术(VHR)是外科医生最常用的手术之一;但是,对执行报告的关键组成部分仍然缺乏协商一致意见。先前的文献已经确定了推荐纳入腹疝修复手术记录的几个关键因素,但尚不清楚这些细节是否单独构成高质量的手术记录。本研究旨在确定专家是否同意哪些因素使腹疝修补手术高质量。研究设计:第1轮采用前瞻性探索性顺序调查为基础的混合方法设计。通过对调查结果的主题分析得出结论,建立主题/次主题,纳入高质量的腹疝修复手术记录。第二轮使用了趋同设计,并试图评估这些确定的主题/子主题的重要性。结果共接触24名外科医生,其中16名完成了两轮手术。9个主题和3个次主题被确定为高质量腹疝修复手术记录中必不可少的内容。第二轮确定了五个最重要的主题,包括准确/充分/相关的细节、清晰的文字、详细/具体/全面的信息、客观的调查结果和程序报告,以及决策的理由/理由。结论基于专家共识,本研究表明高质量的手术记录需要的不仅仅是详细的信息。相反,它们必须结合跨越9个确定主题的质量,以确保清晰度、全面性和有效性。
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来源期刊
Surgery
Surgery 医学-外科
CiteScore
5.40
自引率
5.30%
发文量
687
审稿时长
64 days
期刊介绍: For 66 years, Surgery has published practical, authoritative information about procedures, clinical advances, and major trends shaping general surgery. Each issue features original scientific contributions and clinical reports. Peer-reviewed articles cover topics in oncology, trauma, gastrointestinal, vascular, and transplantation surgery. The journal also publishes papers from the meetings of its sponsoring societies, the Society of University Surgeons, the Central Surgical Association, and the American Association of Endocrine Surgeons.
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