Quality review of ventral hernia repair operative reports

Operative reports are the definitive method for obtaining information regarding the details of a surgery and are essential for optimal patient care and research. Narrative operative reports are often poorly detailed and some surgical specialties have pushed for synoptic reporting, however there is no standardized operative reporting for Ventral Hernia Repair (VHR). This study aims to audit the quality of VHR operative reports.

283 VHR operative reports from a single academic tertiary hospital were retrospectively reviewed for cases done between August 2019 to November 2024. Overall report completeness and reporting frequencies of VHR elements were compared. Variables were categorized into critical, important, and optional variables.

The high-volume surgeon performing ≥ 30 cases annually had overall higher documentation of all variables (90.4% vs. 78.5%, p < 0.001) compared to low volume surgeons, particularly those deemed critical, including hernia size and location of mesh placement (98.9% vs. 79.4%, p < 0.001). Consultant surgeons' dictation had higher documentation of critical variables compared to trainee dictation (91.3% vs. 83.2%, p < 0.001). Compared to reports dictated purely by voice, reports completed on electronic medical record system which prompts certain fields had better documentation of those fields, such as deep vein thrombosis prophylaxis (79.5% vs. 45.6%, p < 0.001), and preoperative antibiotics (88.6% vs. 67.8%, p = 0.009).

There are significant inconsistencies and incomplete documentation in VHR narrative operative reports. The results of this review suggest the implementation of a standardized synoptic operative report for VHR would enhance the quality of operative reports documentation. Furthermore, they support the trend towards major hernia surgeries being done at high volume centers.