FCO-141 24 cases in 2 days!! How to run a successful robotic high intensity theatre (HIT) list: our experience

Background

In 2023, the UK’s first NHS robotic gynaecology High Intensity Theatre (HIT) weekend was successfully carried out at a high-volume tertiary gynaecology unit in London in a bid to tackle excessive local waiting lists following the Covid19 pandemic.

Aim

To share the key experiences of the pre-operative preparation; intra-operative execution and post operative care phases that facilitated the successful completion of the UK’s first NHS robotic gynaecology HIT weekend.

Methods

4 HIT surgical lists were conducted in 2 parallel operating theatres over a span of 2 days running from 0800-2000.

Results

All 24 cases were successfully completed without complication. Surgical procedures were classified as 8% simple; 79% moderate and 13% complex including excision of endometriosis, hysterectomy and salpingo-oophorectomies

High theatre team efficiency was demonstrated with average length of procedure of 69 mins (51-81); average time between patients of 17 minutes (4-42) and 68% of theatre time used for operating. 42% of patients were discharged on the same day and 75% within 24 hours.

The key elements to the success included rigorous pre-operative planning for case selection and patient counselling , optimisation of theatre team efficiency and utilisation of enhanced recovery protocols.

Conclusions

The High intensity theatre (HIT) operating model can be successfully implemented to reduce gynaecology waiting lists in the NHS by careful preoperative planning, optimised teamwork and enhanced recovery protocols.