Does surgeon seniority affect adhesion assessment at cesarean delivery? A prospective study

Area of Science:

• Reproductive Medicine
• Surgical Outcomes
• Medical Education

Background:

• Intraabdominal adhesions are a significant concern following cesarean delivery.
• Adhesion formation can lead to complications and impact patient health.
• Standardized assessment of adhesions is crucial for research and clinical practice.

Purpose of the Study:

• To evaluate the influence of surgeon seniority on the assessment of intraabdominal adhesions during cesarean delivery.
• To determine if experience level affects the reliability of adhesion scoring.
• To investigate interrater reliability in adhesion evaluation among surgeons with varying experience.

Main Methods:

• A prospective study involving 96 pairs of surgeons assessing adhesions at four anatomical sites.
• Surgeons were categorized by seniority: junior residents, senior residents, young attendings, and senior attendings.
• Blinded questionnaires with a 0-8 scoring system were used, and weighted agreement percentages were calculated.

Main Results:

• High interrater reliability was observed, with a weighted agreement of 0.918.
• No significant difference in adhesion scoring was found between senior and less senior surgeons (mean difference of 0.09).
• The results indicate consistent subjective scoring across different levels of surgical experience.

Conclusions:

• Surgeon seniority does not appear to influence the subjective assessment of intraabdominal adhesions.
• The findings suggest that adhesion scoring can be reliable across various experience levels.
• This implies that standardized training may be more critical than seniority for consistent adhesion evaluation.