Invited Critique |

Making Surgery Safer: Can the Operative Reports Help?  Comment on “Operative Reports”

Carlos A. Pellegrini, MD
Arch Surg. 2010;145(9):871-872. doi:10.1001/archsurg.2010.165.
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Stewart et al constructed a “model” operative report for laparoscopic cholecystectomy using cognitive task analysis. With this technique a complex procedure can be decomposed into sequential goals, and within each goal the most effective actions needed to accomplish it are identified. Using this technique they described in an orderly and accurate fashion all aspects of laparoscopic cholecystectomy, creating a model report. The authors compared the content of this model operative report to that of 125 operative reports of laparoscopic cholecystectomy regarding patients who had no BDI during the operation and that of 125 operative reports regarding patients who had sustained such an injury. This work can be examined from 3 perspectives: (1) the accuracy of an operative report to reflect the actions that were actually performed; (2) the relationship between findings and technique (as described in the report) and the occurrence of a BDI; and (3) the potential for the operative report to become a tool to improve the safety of the operation.

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