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OBJECTIVE: Video Assisted Thoracic Surgery (VATS) is a common practice in most countries however, it's still evolving in the Gulf (GCC) region. We suggest a preoperative and operative safety checklist designed to improve team communication and consistency of care. We hypothesized that implementing safety criteria would result in good outcomes and may help start new VATS programs in the region.
METHODS: Between January 2010 and September 2013, we prospectively introduced patients' safety criteria for our VATS patients. Criteria included: Medical reconciliation upon 24 hours of admission (MR 24), Preoperative anesthesia clinic evaluation (PAC),Time out (TO) with Briefing and debriefing (B/B) before surgery. Primary end points were operating room team satisfaction, operative morbidity and mortality, unexpected return to the operating room, unexpected ICU admission and Surgical Site infection (SSI).
RESULTS: A total of 180 VATS patients were included (female 72). All patients (100%) underwent MR 24 with TO and B/B. 153 patients (85%) underwent PAC evaluation. Team satisfaction was noted in 165 (91%) patients. There was no operative mortality. Surgical morbidity was reported in 8 patients (0, 04%). Morbidity included, recurrent pneumothorax (n=2), atelectasis (n=3), persistent air leak (n=2) and retained hemothorax from hereditary coagulopathy (n=1). One patient returned to the operating room for redo VATS pleurectomy. There were no unexpected ICU admissions and no SSI.
CONCLUSIONS: Implementation of the checklist was associated with high team satisfaction with concomitant no mortality and minor morbidity. Introduction of safety criteria may improve outcomes and may help start new VATS programs despite current overall limited VATS experience in the region.