Co-Surgeons in Breast Reconstructive Microsurgery: What Do They Bring to the Table?




Haddock, Nicholas T.
Kayfan, Samar
Kayfan, Samar
Pezeshk, Ronnie A.
Teotia, Sumeet S.

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INTRODUCTION: Current research within other surgical specialties suggests that a co-surgeon approach may reduce operative times and complications associated with complex bilateral procedures, possibly leading to improved patient and surgical outcomes. We sought to evaluate the role of the co-surgery team and its development in free flap breast reconstruction. METHODS: A retrospective review of free-flap breast reconstruction by two surgeons from 2011-2016 was conducted. We analyzed 128 patients who underwent bilateral-DIEP breast. Surgical groups were: single-surgeon reconstruction (SSR; 35 patients), Co-Surgery where both surgeons are present for entire reconstruction (CSR-I; 69 patients), and Co-Surgery reconstruction where co-surgeons appropriately assist in two concurrent or staggered cases (CSR-II; 24 patients). Efficiency data collected was OR time and patient length-of-stay (LOS). The rate of flap-failure, return to OR, infection, wound breakdown, seroma, hematoma and PE/DVT were compared. RESULTS: Single-surgeon reconstruction had significantly longer OR time (678 vs 485 minutes, p< 0.0001), LOS (5 vs 3.9 days, p<0.001), higher wound occurrences of the umbilical site that required surgical correction [11.4 percent (n=4) versus 1.5 percent,(n=1); p<0.043] compared to CSR-I. Similarly, SSR had significantly longer average OR time (678 vs 527 minutes p< 0.0001), average LOS (5 days vs 4 days, p=0.0005) when compared to CSR-II. There were no total increased patient related complications associated with co-surgery (CSR- I or II). CONCLUSION: The addition of a Co-surgeon, even with concurrent surgery, reduces operative time, average patient LOS, and post-operative complications. This work lends a strong credence that Co-surgery model is associated with increased operative efficiency.

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As the content in this document has been previously published in the journal Microsurgery, an internal indefinite embargo will be placed on this document through the department of Medical Student Research at UT Southwestern. This will ensure that this document will not be published online and will remain only within the UT Southwestern system to not infringe upon copyright regulations established between the authors and Microsurgery.
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Haddock, N. T., Kayfan, S., Pezeshk, R. A., & Teotia, S. S. (2018). Co-surgeons in breast reconstructive microsurgery: What do they bring to the table?. Microsurgery, 38(1), 14–20.