Working with a pre-operative checklist in laparoscopic surgery, an initial study


Background: Major changes in endoscopic surgery have taken place in recent years. More and more, technical applications and complicated devices are introduced in the operation room. In previous studies, various preventable equipment related problems are reported. Potentially, this can influence the quality and safety of laparoscopic surgery. The goal of study is to find out if working with a pre-operative checklist can influence various aspects of laparoscopic procedures.

Methods: 121 consecutive procedures were closely observed and analyzed. In the first phase, the 25 participating surgeons and residents were observed during the procedures. They also filled in a questionnaire after finishing their procedure. In the second phase, they additionally filled in a pre-operative checklist. With the checklist, verification of patient data and patient positioning were performed, also instruments and hardware components were checked.

Results: When working with the checklist, two out of three time-slots were reduced. Preparation time declined from 12.4 to 9.7 minutes. Patient identification improved after introduction of the checklist. Identification was not performed in 20.3% of the cases in the first phase, this declined to 13.0% in the second phase. With a checklist, it was less often necessary to correct the patients position: 12.2% vs. in 23.2%. Instrument verification improved with the checklist from 4.8% to 14.6%. Positioning of the monitor was done more often in checklist group (34.5%), compared to the first phase group (9.3%).
Higher satisfaction rates in post-procedure questionnaires were reported when working with the checklist.

Conclusion: This initial study of working with a pre-operative checklist in laparoscopic surgery showed clear benefits. It can save time and improve pre-operative preparation. Possible technical and practical errors can be detected. More research projects are necessary to demonstrate the role of checklists in laparoscopic surgery.

Key words: checklist, laparoscopy, minimal invasive surgery, advanced operation room

Session: Podium Presentation

Program Number: S053

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