Use of surgical procedure manager to standardise operation steps and monitor surgeon performance in open repair of inguinal hernia

Objectives

To study the feasibility of using surgical procedure manager (SPM), a digital checklist platform, to standardise surgical steps of open hernia repair and monitor the operative performance.

Methodology

A retrospective study on all open mesh repair of inguinal hernia under local anaesthesia from September 2019 to November 2021 at the Prince of Wales Hospital was performed. The operative outcomes of patients having operations with or without the use of SPM were compared. Procedures using SPM had operation steps shown as a digital checklist inside the theatre. The time used for each surgical step was recorded and analysed. The operative performance of the surgeons was analysed by observing the trend of the mean operation time over time.

Results

A total of 123 patients were recruited, of which 52 were using the SPM. The median age of patients was 75 (range 49–93) years. A decreasing trend in the mean operation time for dissection, mesh placement, wound closure and total operation time was observed in surgeries using SPM. There was no significant difference in the operation time, theatre time, total length of stay, blood loss and readmission rate between the SPM and non-SPM groups. The proportion of basic surgical trainees as coached surgeons in the SPM group was significantly higher (SPM = 52% vs non-SPM = 28%, P = .07).

Conclusions

The use of SPM did not significantly prolong the operation time and produce comparable operative outcomes in open hernia repair. It provided the additional advantage of standardising operation steps and monitoring the performance of surgical trainees during their training.