Value of a preoperative checklist for laparoscopic appendectomy and cholecystectomy.

ABSTRACT

UNLABELLED Laparoscopy is a complex technique where incidents related to equipment failure/malfunction commonly occur. The purpose of the WHO preoperative safety checklist is to significantly reduce surgically associated complications and mortality. GOAL The goal of this study was to show that a preoperative checklist for laparoscopy could improve procedure efficiency by reducing lost time due to these incidents. MATERIAL AND METHODS: This prospective study compared the occurrence of incidents related to equipment, patient installation and the time loss attributed to these incidents, before and after the initiation of a preoperative checklist. Two hundred consecutive laparoscopic procedures (appendectomies and cholecystectomies) were studied; the first hundred without the preoperative checklist and the second hundred after the initiation of this laparoscopic checklist. RESULTS: The risk of at least one incident to occur during the procedure was increased 3-fold ([1.36 vs. 6.64], P=0.007) when the checklist was not used compared to when the preoperative checklist was used. Likewise, the number of incidents increased 2.4-fold ([1.15; 5.01], P=0.02), compared to when the preoperative checklist was used. The checklist significantly reduced the proportion of incidences during which time was lost from 22% to 10% (P=0.03). CONCLUSION: A preoperative checklist for laparoscopic procedures is feasible and seems useful to prevent adverse events in the operating room.