A quality improvement study of practising surgeons showed that better operative technical skills are associated with lower rates of postoperative complications, according to an article published in JAMA Surgery.
The analysis included 17 surgeons that submitted a video of a laparoscopic right hemicolectomy to be rated by blinded peer surgeons and expert colorectal surgeons. The main outcomes were any complication, mortality, unplanned hospital readmission, unplanned reoperation related to the principal procedure, surgical site infection, and death or serious morbidity.
Based on 10 or more reviewers per video and with a maximum quality score of five, overall technical skill scores ranged from 2.8 to 4.6. Higher technical skill scores were significantly associated with lower rates of any complication (15.5% versus 20.6%), unplanned reoperation (4.7% versus 7.2%), and a composite measure of death or serious morbidity (15.9% versus 21.4%) following colectomy. Overall, technical skill scores appeared to account for 25.8 per cent of the variation in post-colectomy complication rates and 27.5 per cent of the variation when including non-colectomy complication rates.
The authors note that each one-point improvement in technical skill score was associated with a 3.1 per cent absolute decrease in post-colectomy complication rates, which suggests that efforts to improve surgeon technical skill scores could improve patient outcomes.