Associations between intraoperative factors and surgeons’ self-assessed operative satisfaction

Abstract

Background: Little is known concerning what may infuence surgeon satisfaction with a surgical procedure and its associations with intraoperative factors. The objective was to explore the relationships between surgeons’ self-assessed satisfaction with performed radical prostatectomies and intraoperative factors such as technical difculties and intraoperative complications as reported by the surgeon subsequent to the operation. Methods: We utilized prospectively collected data from the controlled LAPPRO trial where 4003 patients with prostate cancer underwent open (ORP) or robot-assisted laparoscopic (RALP) radical prostatectomy. Patients were included from fourteen centers in Sweden during 2008–2011. Surgeon satisfaction was assessed by questionnaires at the end of each operation. Intraoperative factors included time for the surgical procedure as well as difculties and complications in various steps of the operation. To model surgeon satisfaction, a mixed efect logistic regression was used. Results were presented as odds ratios (OR) with 95% confdence intervals (CI). Results: The surgeons were satisfed in 2905 (81%) and dissatisfed in 702 (19%) of the surgical procedures. Surgeon satisfaction was not statistically associated with type of surgical technique (ORP vs. RALP) (OR 1.36, CI 0.76; 2.43). Intraoperative factors such as technical difculties or complications, for example, suturing of the anastomosis was negatively associated with surgeon satisfaction (OR 0.24, CI 0.19; 0.30). Conclusions: Our data indicate that technical difculties and/or intraoperative complications were associated with a surgeon’s level of satisfaction with an operation.