The Financial Impact of a Co-Surgeon in Breast Microsurgery

• Published in: Plastic and reconstructive surgery (1963)
• Main Authors: DeVito, Robert G, Ke, Benjamin G, Park, Rachel H, Hollenbeck, Scott T, Campbell, Chris A, Stranix, John T
• Format: Journal Article
• Language: English
• Published: United States 01-01-2024
• ISSN: 0032-1052; 1529-4242; 1529-4242
• DOI: 10.1097/PRS.0000000000011791

Co-surgeon approaches for autologous breast reconstruction have demonstrated improvements in operative efficiency. The health system financial impact, however, warrants further investigation.
Retrospective review of consecutive autologous reconstructions between 2017-2022. Primary outcome measures: length of stay (LOS), operative time, and financial metrics. Cases were stratified by co-surgeon presence, timing, and laterality.
264 cases met inclusion criteria; there were 117 co-surgeon and 147 single surgeon cases. Co-surgeon cases demonstrated decreased LOS (2.4 vs. 3.1 days; p < 0.01), decreased operative time in unilateral (269 vs. 370 minutes; p < 0.01) and bilateral cases (399 vs. 582 minutes; p < 0.01). Co-surgeon cases were also associated with decreased total cost ($25,160 vs. $31,758; p < 0.01), direct cost ($15,558 vs. $19,283; p < 0.01), indirect cost ($9,602 vs. $12,475; p < 0.01), decreased total charges ($98,728 vs. $120,981; p < 0.01), and increased margin ($1,099 vs. -$6,255; p < 0.01). Post hoc analysis revealed significant differences, albeit at varying magnitudes, in these particular metrics across all levels of reconstruction timing with the inclusion of a co-surgeon.
Co-surgeon breast microsurgery not only improves operative efficiency, but also translates to improved financial metrics. As we transition to value-based care models, this is particularly relevant to health systems offering microsurgical breast reconstruction. Analyses of downstream benefits including optimized patient throughput and surgeon opportunity cost warrant investigation.