Scholarlink

Background <p>Operative time in complex ventral hernia repair is influenced by multiple patient-, hernia-, and procedure-related factors. However, total operative duration provides limited insight into how time is distributed across individual steps of the operation and which phases contribute most to variability.</p> Methods <p>This observational cohort study included 93 consecutive patients undergoing open complex ventral hernia repair with abdominal wall reconstruction. The operation was divided a priori into seven predefined workflow phases comprising seventeen detailed operative segments. Total operative time and phase-specific durations were recorded prospectively. Time distribution and variability were assessed using descriptive statistics and coefficients of variation. Associations between operative time and patient-, hernia-, and procedure-related factors were analysed using non-parametric tests and multivariable regression.</p> Results <p>The median total operative time was 167&#xa0;min (IQR 145–194). Retromuscular dissection with posterior component separation accounted for the largest proportion of operative time. Adhesiolysis and posterior component separation demonstrated the greatest variability, whereas mesh placement, hemostasis, and final closure phases showed low variability. Larger hernia defect area, hernia recurrence, and bilateral transversus abdominis release were significantly associated with longer operative time. In multivariable analysis, defect size, recurrent hernia, and bilateral posterior component separation remained independently associated with prolonged operative duration, while body mass index was not.</p> Conclusions <p>Operative time in open complex ventral hernia repair is driven primarily by a limited number of highly variable intraoperative phases rather than uniform prolongation of the entire procedure. Phase-based workflow analysis provides a structured benchmark for operative planning, process optimisation, and future comparisons with emerging surgical technologies.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Time distribution and intraoperative workflow in complex midline incisional hernia repair

  • 期刊论文

  • 发表日期：

    2026年4月24日

查看全文
  • Kryspin Mitura,
  • Michal Romanczuk,
  • Laura Kacprzak,
  • Piotr Niecikowski,
  • Lidia Mitura,
  • Piotr Konrad Leszczynski,
  • Bernard Mitura,
  • Orest Lerchuk,
  • Volodymyr Khomyak,
  • Orest Chemerys

摘要

Background

Operative time in complex ventral hernia repair is influenced by multiple patient-, hernia-, and procedure-related factors. However, total operative duration provides limited insight into how time is distributed across individual steps of the operation and which phases contribute most to variability.

Methods

This observational cohort study included 93 consecutive patients undergoing open complex ventral hernia repair with abdominal wall reconstruction. The operation was divided a priori into seven predefined workflow phases comprising seventeen detailed operative segments. Total operative time and phase-specific durations were recorded prospectively. Time distribution and variability were assessed using descriptive statistics and coefficients of variation. Associations between operative time and patient-, hernia-, and procedure-related factors were analysed using non-parametric tests and multivariable regression.

Results

The median total operative time was 167 min (IQR 145–194). Retromuscular dissection with posterior component separation accounted for the largest proportion of operative time. Adhesiolysis and posterior component separation demonstrated the greatest variability, whereas mesh placement, hemostasis, and final closure phases showed low variability. Larger hernia defect area, hernia recurrence, and bilateral transversus abdominis release were significantly associated with longer operative time. In multivariable analysis, defect size, recurrent hernia, and bilateral posterior component separation remained independently associated with prolonged operative duration, while body mass index was not.

Conclusions

Operative time in open complex ventral hernia repair is driven primarily by a limited number of highly variable intraoperative phases rather than uniform prolongation of the entire procedure. Phase-based workflow analysis provides a structured benchmark for operative planning, process optimisation, and future comparisons with emerging surgical technologies.