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Invited Critique
Oct 2011

Too Much of a Good Thing or Operating at the Fringe: Comment 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.1-3 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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