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Related Experiment Video

Updated: May 15, 2025

Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction

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The 'hub' model for colorectal surgery: a viable paradigm shift?

P Janardhanan¹, A Khalid¹, M H Anwaar¹

¹University Hospitals Birmingham NHS Foundation Trust, UK.

Annals of the Royal College of Surgeons of England

|April 8, 2025

Summary

The elective surgery hub model effectively managed major colorectal surgeries post-COVID-19 lockdown, showing good safety and minimal patient disruption. This approach enhances surgical system resilience and patient outcomes.

Keywords:

COVID-19 Colorectal surgery Hub New Deal

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Area of Science:

Surgical innovation
Healthcare management
Public health

Background:

Post-COVID-19 lockdown, 7 million patients faced elective surgery waiting lists.
The Royal College of Surgeons proposed a 'New Deal for Surgery' using COVID-light sites and elective hubs.
This study evaluates the short-term outcomes, safety, and sustainability of the elective hub model.

Purpose of the Study:

To assess the efficacy and safety of the elective hub model for major colorectal surgery.
To evaluate patient outcomes, including complications, readmissions, and length of stay.
To determine the sustainability and system resilience benefits of the hub model.

Main Methods:

Analysis of all major elective colorectal operations performed at the hub between March 2021 and March 2022.
Inclusion of data on patient demographics, operative performance, and postoperative outcomes.
Statistical analysis using SPSS 27.

Main Results:

401 cases were analyzed with a 0.2% same-day cancellation rate.
8.2% experienced severe complications (Clavien-Dindo grade ≥3), and 8.5% required transfer for higher care.
11.5% had 30-day readmissions, and 0.4% mortality rate was observed.

Conclusions:

The elective hub model demonstrated efficacy and safety in managing high volumes of major colorectal surgery.
Acceptable rates of major complications, transfers, and minimal patient displacement were noted.
The model contributes to improved surgical system resilience and patient care post-pandemic.