Enhancing Operative Documentation of Emergency Laparotomy: A Systematic Review and Development of a Synoptic Reporting Template

Abstract

Abstract Introduction: Currently operative reports are narrative, often hand-written making interpretation difficult and potentially omitting key steps of the procedure. This study undertook a systematic review to determine current availability of synoptic operative reporting and develop a synoptic operative record template for emergency laparotomy (EL). Methods: A PROSPERO registered study from January 1st, 2012, to December 31st, 2022, was conducted using PubMed, Scopus, and Web of Science databases in February 2023. Keywords included: emergency laparotomy AND operation notes OR operative notes OR documentation OR report OR proforma OR narrative OR synoptic OR digital OR audio-visual. Studies of paediatric or pregnant patients as well as systematic reviews, meta-analyses, case reports, editorial comments, and letters were excluded. A synoptic operative record was designed to include key standards in documentation as suggested by the Colleges of Surgeons. Results: The literature search produced 4,687 articles and no relevant published articles were found. A detailed synoptic template was developed, including 111 fields related to patient demographics, operative findings, intervention, and documentation of key variables associated with patient outcomes. 11 were text boxes, two related to digital audio-visual uploads and three facilitating digital scoring/grading of findings. Conclusion: This systematic review identified a limited number of publications reporting synoptic operative reporting and none relating to emergency laparotomy. The novel operative template provides a platform for clear documentation of the surgery performed during emergency laparotomy, potentially facilitating data analysis, resident training, and research and in turn leading to a better understanding of patient outcomes.