Kannan J, Shelat VG. Standardized handover in gastrointestinal surgery: From checklist adoption to safety culture. World J Gastrointest Surg 2026; 18(6): 120266 [DOI: 10.4240/wjgs.120266]
Corresponding Author of This Article
Vishal G Shelat, Associate Professor, Consultant, FRCS (Gen Surg), Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore. vgshelat@rediffmail.com
Research Domain of This Article
Health Care Sciences & Services
Article-Type of This Article
review-article
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jun 27, 2026; 18(6): 120266 Published online Jun 27, 2026. doi: 10.4240/wjgs.120266
Standardized handover in gastrointestinal surgery: From checklist adoption to safety culture
Janani Kannan, Vishal G Shelat
Janani Kannan, Department of General Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
Vishal G Shelat, Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore
Author contributions: Shelat VG conceptualized and designed the study, supervised, and made critical revisions; Kannan J and Shelat VG conducted the literature review, consolidated the data, drafted the manuscript, and made critical revisions; and all authors contributed to preparation of the draft and approved the submitted version.
AI contribution statement: ChatGPT (OpenAI) was used as an editorial support tool during preparation of this manuscript, including assistance with wording refinement, language polishing, organization of text, and preparation of the figure concept. Grammarly, DeepL, and other AI-based translation tools were not used. No section of the manuscript was produced entirely by AI. The intellectual content, literature selection, interpretation, conclusions, and final wording were reviewed, verified, revised, and approved by the authors. AI was not used for data analysis, statistical analysis, study design, or interpretation of results. Figure 1 was not prepared with AI-assisted editorial/visual support. The figure does not contain patient images, identifiable patient information, or copyrighted third-party material. The authors accept full responsibility for the accuracy, integrity, and final content of the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Corresponding author: Vishal G Shelat, Associate Professor, Consultant, FRCS (Gen Surg), Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore. vgshelat@rediffmail.com
Received: February 24, 2026 Revised: March 5, 2026 Accepted: April 2, 2026 Published online: June 27, 2026 Processing time: 118 Days and 18.8 Hours
Abstract
Postoperative handover in gastrointestinal (GI) surgery is a safety-critical transfer of information, responsibility, and control, not a clerical endpoint to the operation. We discuss various handover systems for post-anesthesia GI surgery patients that reports fewer omissions, fewer recovery-period events, and higher staff satisfaction despite a modest increase in handover duration. The existing literature on the theme is clinically relevant and implementation-oriented, but interpretation should remain cautious because time-sequenced non-randomized designs are vulnerable to secular trends, learning effects, staffing variation, and surveillance bias. The next step is not checklist adoption alone, but governance-owned implementation: Risk-tiered standardization, receiver verification, explicit escalation triggers, audit feedback, and reporting of balancing measures such as throughput, clarification workload, and cognitive burden. In practice, teams should CLOSE the loop-confirm key facts, loop-back with read-back, own the plan, signal rescue triggers, and evaluate understanding-so handover becomes a verified transfer of care rather than a one-way recital.
Core Tip: Post-anesthesia handover in gastrointestinal surgery should be treated as a high-risk transition and a reliability intervention. Standardized content matters, but durable benefit depends on active receiver engagement, clear accountability, escalation planning, and audit feedback. At the bedside, teams should CLOSE the loop-confirm, loop-back, own the plan, signal rescue triggers, and evaluate understanding-to reduce omissions while preserving workflow discipline.
