Impact of Structural Anomalies and Anatomical Variations on Operative Time in Abdominal Surgery-Systematic Review

Area of Science:

• Surgical Outcomes
• Anatomical Variations
• Operative Efficiency

Background:

• Prolonged operative time increases surgical complications, resource use, and costs.
• Factors like surgeon experience and patient characteristics are known to affect operative time.
• The impact of anatomical anomalies and variations on operative time is not well quantified.

Purpose of the Study:

• To systematically review the influence of abdominal structural anomalies and anatomical variations on operative time.
• To quantify the added operative time associated with these anatomical differences.
• To assess the impact of procedural complexity and preoperative planning on operative duration.

Main Methods:

• Systematic review following PRISMA 2020 guidelines.
• Literature search of PubMed (2000-2025) yielding 82 eligible studies.
• Analysis of operative time impact using added operative time relative to benchmarks, stratified by procedure category and complexity.

Main Results:

• 92.9% of structural anomalies, 88.9% of situs inversus cases, and 90.9% of other anatomical variants increased operative time.
• Structural anomalies, especially in colorectal procedures, showed larger increases.
• Higher-complexity procedures, like pancreatic operations, had greater absolute increases in operative time.

Conclusions:

• Structural anomalies frequently increase operative duration, while anatomical variations have a variable effect.
• Procedural complexity and preoperative planning significantly influence the magnitude of operative time impact.
• Incorporating anatomical variability into surgical planning can reduce delays and enhance operative efficiency.