Effects of establishing a daytime emergency operating theatre in a university hospital - 27/11/25

Doi : 10.1016/j.jviscsurg.2025.10.010

Ida Nathalie Strømnes Nordvoll ^a, Vilde Olsen Kjernli ^a, Lena Ringstad Olsen ^b, Bjørn Olden Nedrebø ^c, Guttorm Brattebø ^a,^d, Reidar Kvåle ^a,^d,⁎

^a University of Bergen, Bergen, Norway

^b Statitician, Center for Clinical Documentation and Evaluation (SKDE), Northern Norway Regional Health Authority, Tromsø, Norway

^c Department of Surgery, Haukeland University Hospital, Haukeland, Norway

^d Department of Anaesthesia and Intensive care, Haukeland University Hospital, Haukeland, Norway

^⁎ Corresponding author. University of Bergen, 5021 Bergen, Norway. University of Bergen Bergen 5021 Norway

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Thursday 27 November 2025

Highlights

•	After establishment of a daytime emergency operating theatre the total number of emergency laparotomies increased, and a higher proportion was performed during daytime hours.
•	A higher proportion of acute surgeries was requested with high priority, but nevertheless a higher proportion took place within priority.
•	More elderly patients underwent acute surgery.
•	The number of cancellations of scheduled surgeries was significantly reduced.
•	Key outcomes, including hospital length of stay, reoperation rates within seven days, and 30-day mortality remained unchanged.
•	The study highlights both the benefits and potential challenges of increasing surgical theatre availability.

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Summary

Aim of the study

Acute abdominal surgery, constituting a substantial portion of hospital services, is associated with high morbidity and mortality rates. This study aimed to compare two cohorts of emergency laparotomy surgeries: before (Cohort 1) and after (Cohort 2) the establishment of a regular daytime emergency operating theatre at Haukeland University Hospital, Norway.

Patients and methods

Data were collected from the hospital's operation planning and registration system and then merged with data from the hospital's electronic patient record system. The British National Emergency Laparotomy Audit (NELA) inclusion and exclusion criteria were used.

Results

The study found an increase from Cohort 1 to Cohort 2 in the number of surgeries, and in the proportion of urgent surgeries, both requested and started, within 6 h. Results also showed a higher proportion of daytime surgeries in the latter cohort. More elderly patients were operated in Cohort 2, but the low 30-day mortality rate remained unchanged. Other key outcomes, such as length of hospital stay and reoperations within seven days, were also unchanged. The number of cancellations of scheduled surgery was significantly lower after a regular daytime emergency surgery room was available.

Conclusion

While improvements were found, the study acknowledges potential challenges and costs associated with the increasing availability of surgical theatres. The findings contribute to ongoing discussions on optimizing acute abdominal surgery pathways.

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Keywords : Acute abdominal surgery, Laparotomy, Operation theatre, Priority, Outcome