Introducing the "Twilight" operating room concept: a feasibility study to improve operating room utilization

The efficient use of operating room is important to ensure optimum cost-benefit for the hospital and to reduce elective surgery waiting times. We introduced a concept of non-commissioned "Twilight" operating room to reduce patient waiting list and mitigate consequences of non-availability of elective operative time due to closure of an affiliated hospital operating suite.

A retrospective audit was performed during a 10-month period where "Twilight" operating room was implemented in our institution. Additionally, we included patients that were operated on 13 non-commissioned whole day operative sessions on Saturdays during the same period.

A total of 223 surgical procedures were performed during the study time window. Most patients have American Society of Anaesthesiologists (ASA) Class 2. Participating subspecialties were General Surgery, Orthopaedic surgery, Gynaecology, Urology, Plastic surgery and Dental surgery. A wide range of operations was performed in the "Twilight" operating room. No major complications were observed.

Our study demonstrated the feasibility of conducting elective surgeries after hours with the advantage of reducing the hospital's elective surgery waiting time. Importantly, no major post-operative complications were reported. This model is a feasible and safe strategy to restore surgical activity impacted by the COVID-19 pandemic.