A novel pre-abdominal closure checklist in colorectal surgery serves as a critical defensive barrier against human errors.
6 affiliations
- 1Department of Surgery, Kochi Medical School, Kochi University, Oko-cho, Nankoku, 783-8505, Kochi, Japan.
- 2Department of Surgery, Kochi Medical School, Kochi University, Oko-cho, Nankoku, 783-8505, Kochi, Japan. [email protected].
- 3Department of Clinical Nursing, Kochi Medical School, Kochi University, Nankoku, Japan.
- 4Department of Public Health, Kochi Medical School, Kochi University, Nankoku, Japan.
- 5Medical safety management center, Kochi Medical School, Kochi University, Nankoku, Japan.
- 6Department of Anesthesiology and Intensive Care Medicine, Kochi Medical School, Kochi University, Nankoku, Japan.
Abstract
Background
The use of a checklist during abdominal closure may reduce human error and improve surgical safety. To address this benefit, we evaluated the effectiveness of an institutional checklist by determining whether implementation led to additional procedures.Methods
A 12‑item pre‑closure checklist for colorectal surgery was developed and incorporated into practice in late May 2024. We retrospectively reviewed checklist findings documented in electronic medical records. Surgical outcomes were compared between 42 cases with and 409 cases without checklist use during 2020-2024.Results
Of 45 patients, checklist information was unavailable for three. Among 42 remaining patients, additional intraoperative procedures were required in four cases following checklist use. Procedures included injury repair or hemostasis (n = 1), application of antiadhesion agents (n = 2), and repositioning of intestine or omentum to the original position (n = 1). No incidents involving retained gauze, residual tissue, or deviations from planned procedures were identified. Among four cases requiring additional interventions, two involved multiple ancillary procedures and two required extended operative duration. No significant differences were observed between groups in anastomotic leakage, complication rate, or length of postoperative hospitalization.Conclusions
The pre-closure checklist facilitated the identification of intraoperative errors that otherwise might have been overlooked. Additional studies with a larger patient population, broader range of surgical procedures, and multiple institutions are needed to further clarify its utility.
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BibTeX
@article{marui2026novel,
title = {{A novel pre-abdominal closure checklist in colorectal surgery serves as a critical defensive barrier against human errors.}},
author = {Akira Marui and Hiromichi Maeda and Sachi Yamaguchi and Yasuhiro Kawanishi and Masahiro Maeda and Nobuhisa Tanioka and Kazune Fujisawa and Hiroyuki Kitagawa and Tsutomu Namikawa and Ichiro Miyano and Motohiko Kume and Takashi Kawano and Satoru Seo},
journal = {Langenbeck's archives of surgery},
year = {2026},
month = jul,
doi = {10.1007/s00423-026-04160-w},
url = {https://europepmc.org/article/MED/42907617},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - A novel pre-abdominal closure checklist in colorectal surgery serves as a critical defensive barrier against human errors.
AU - Akira Marui
AU - Hiromichi Maeda
AU - Sachi Yamaguchi
AU - Yasuhiro Kawanishi
AU - Masahiro Maeda
AU - Nobuhisa Tanioka
AU - Kazune Fujisawa
AU - Hiroyuki Kitagawa
AU - Tsutomu Namikawa
AU - Ichiro Miyano
AU - Motohiko Kume
AU - Takashi Kawano
AU - Satoru Seo
PY - 2026
DA - 2026/07/25
JO - Langenbeck's archives of surgery
DO - 10.1007/s00423-026-04160-w
UR - https://europepmc.org/article/MED/42907617
AB - Background The use of a checklist during abdominal closure may reduce human error and improve surgical safety. To address this benefit, we evaluated the effectiveness of an institutional checklist by determining whether implementation led to additional procedures.Methods A 12‑item pre‑closure checklist for colorectal surgery was developed and incorporated into practice in late May 2024. We retrospectively reviewed checklist findings documented in electronic medical records. Surgical outcomes were compared between 42 cases with and 409 cases without checklist use during 2020-2024.Results Of 45 patients, checklist information was unavailable for three. Among 42 remaining patients, additional intraoperative procedures were required in four cases following checklist use. Procedures included injury repair or hemostasis (n = 1), application of antiadhesion agents (n = 2), and repositioning of intestine or omentum to the original position (n = 1). No incidents involving retained gauze, residual tissue, or deviations from planned procedures were identified. Among four cases requiring additional interventions, two involved multiple ancillary procedures and two required extended operative duration. No significant differences were observed between groups in anastomotic leakage, complication rate, or length of postoperative hospitalization.Conclusions The pre-closure checklist facilitated the identification of intraoperative errors that otherwise might have been overlooked. Additional studies with a larger patient population, broader range of surgical procedures, and multiple institutions are needed to further clarify its utility.
SN - 1435-2443
SN - 1435-2451
ER -