Commentary: Risk of overlapping surgery in cardiac surgery? Much ado about nothing

Abstract

Overlapping surgery is a relatively new term for physicians, patients, and health policy agencies to describe a longstanding practice that has been fairly common in cardiothoracic surgery: the practice of running 2 operative rooms. In 2015, this concept gained wide attention after an expos e was published by the Boston Globe Spotlight Team regarding potential risks and lack of patient awareness of the practice1 ; soon thereafter, publications regarding overlapping surgery followed from orthopedic and other surgeons, some focusing on its controversy and ethics.2-5 Overlapping surgery is described as the practice of the primary responsible surgeon participating in another operation after critical portions of the first operation are completed; typically, this is done with the understanding that there is no need for the primary responsible surgeon to return to the first operation. Usually, the primary responsible surgeon is defined as the surgeon who performs all critical parts of the procedure and is always available to return the operating room if needed. Although there is no formal definition of the ‘‘critical’’ components of a procedure, these are generally considered to be those portions of the operation that require the surgeon’s specific expertise.