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Invited Critique
Oct 2011

Too Much of a Good Thing or Operating at the FringeComment on “National Register Study of Operating Time and Outcome in Hernia Repair”

Author Affiliations

Author Affiliations: Division of Plastic Surgery (Dr Carty), Department of General Surgery (Dr Ashley), Brigham and Women's Hospital, Boston, Massachusetts.

Arch Surg. 2011;146(10):1203. doi:10.1001/archsurg.2011.260

The relationship between surgical volume and performance continues to be a subject of considerable interest to surgeons, patients, and payors. In general, studies to date have made the intuitive observation that with increasing procedure frequency and/or surgeon experience, there is a proportional—and sometimes logarithmic—decline in operative time, operative time variability, and complication rate.13 These findings are relevant in their implications for the allocation of finite operative resources, as well as for approaches to surgical education and continuing professional development.

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