Tan YZ, Yang M. Standardized instrument setup shortens operating time and reduces interruptions in laparoscopic gastrointestinal surgery: A single-centre randomized control trial. World J Gastrointest Surg 2026; 18(4): 116399 [DOI: 10.4240/wjgs.v18.i4.116399]
Corresponding Author of This Article
Min Yang, Research Fellow, Department of Anesthesiology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi 445000, Hubei Province, China. 574423227@qq.com
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Gastroenterology & Hepatology
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Randomized Controlled Trial
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Apr 27, 2026 (publication date) through Apr 24, 2026
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Publication Name
World Journal of Gastrointestinal Surgery
ISSN
1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Tan YZ, Yang M. Standardized instrument setup shortens operating time and reduces interruptions in laparoscopic gastrointestinal surgery: A single-centre randomized control trial. World J Gastrointest Surg 2026; 18(4): 116399 [DOI: 10.4240/wjgs.v18.i4.116399]
World J Gastrointest Surg. Apr 27, 2026; 18(4): 116399 Published online Apr 27, 2026. doi: 10.4240/wjgs.v18.i4.116399
Standardized instrument setup shortens operating time and reduces interruptions in laparoscopic gastrointestinal surgery: A single-centre randomized control trial
Yuan-Zhen Tan, Min Yang
Yuan-Zhen Tan, Min Yang, Department of Anesthesiology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi 445000, Hubei Province, China
Author contributions: Tan YZ is responsible for research design, data processing, and paper writing; Yang M is responsible for coordinating research, revising final drafts, and academic communication. The authors all acknowledge the final draft.
Institutional review board statement: The procedures for both T1 and T2 surveys adhered to the Declaration of Helsinki, and ethical principles for medical, psychological, and sociological research involving human participants. The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture Research Ethics Committee approved the study protocol.
Clinical trial registration statement: This randomized controlled trial remained unregistered pre-initiation per its clinical design features.
Informed consent statement: All the individuals who participated in this study provided their written informed consent prior to study enrolment.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: No additional data are available.
Corresponding author: Min Yang, Research Fellow, Department of Anesthesiology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi 445000, Hubei Province, China. 574423227@qq.com
Received: December 2, 2025 Revised: January 7, 2026 Accepted: February 6, 2026 Published online: April 27, 2026 Processing time: 142 Days and 21.2 Hours
Abstract
BACKGROUND
Laparoscopic gastrointestinal surgery instruments are complex, and traditional management models rely on nurses’ personal experiences, which can easily lead to intraoperative interruptions. Standardized instrument settings aim to improve team collaboration, efficiency, and surgical safety through a unified process.
AIM
To explore the application of an operating room nurse-led standardized laparoscopic instrument setup model to optimize laparoscopic gastrointestinal surgery.
METHODS
A total of 120 patients undergoing laparoscopic gastrointestinal surgery between June 2022 and June 2025 were divided into observation (n = 60) and control (n = 60) groups using the random number table method. The control group adopted the traditional instrument management model. The observation group implemented a standardized instrument setup (SIS) scheme formulated under the leadership of operating room nurses. Surgical efficiency indicators, clinical outcome indicators, postoperative complication rates, team subjective evaluations, and cognitive load levels were compared between groups.
RESULTS
Compared with the control group, the observation group showed shorter median operating-room occupancy time (185.6 ± 28.4 minutes vs 205.3 ± 32.1 minutes, P < 0.001), surgical preparation time (18.5 ± 3.2 minutes vs 25.8 ± 4.7 minutes, P < 0.001), and core surgical time (152.7 ± 25.6 minutes vs 168.9 ± 30.3 minutes, P = 0.001). Unplanned interruptions decreased (4.6 ± 1.5 events per case to 1.2 ± 0.8 events per case, P < 0.001), including instrument-related interruptions (2.8 ± 1.1 to 0.5 ± 0.7, P < 0.001) and communication-related interruptions (1.1 ± 0.8 to 0.3 ± 0.5, P < 0.001). Effective instrument handover rate increased (95.2% to 99.1%, P < 0.001), and mean handover time decreased (2.8 ± 0.6 seconds to 1.5 ± 0.3 seconds, P < 0.001). Post-operative overall complication rate reduced (25.0% to 10.0%, χ² = 4.675, P = 0.031).
CONCLUSION
Nurse-led SIS can significantly operative efficiency, reduce invalid operations and unplanned interruptions, and improve the overall collaborative tacit understanding and work efficiency, supporting further clinical promotion and application.
Core Tip: This study demonstrated that an operating room nurse-led standardized instrument setup (SIS) model significantly enhanced the efficiency of laparoscopic gastrointestinal surgery. Compared to the traditional experience-based approach, the SIS reduced operating room occupancy time, unplanned interruptions, and instrument handover errors, while improving patient outcomes and lowering the cognitive load for surgeons and scrub nurses. This nurse-driven, standardized protocol optimizes workflow and team collaboration and offers a reproducible model for improving surgical safety and efficiency.
