Dedicated operating room teams for highly specialized procedures in a tertiary children's hospital: the Rotterdam experience

Complex, high-risk pediatric surgical procedures, which are typically initially executed with limited case volumes, present challenges for pediatric surgeons and pediatric anesthesiologists. To attain the highest standards, organizational efforts are also essential. Drawing from personal experience at a large tertiary children's hospital, and supported by evidence from scientific literature, this article delineates the challenges, benefits, indications, and potential alternatives for establishing dedicated operating room teams. At Erasmus MC Sophia Children's Hospital, a dedicated operating room team for neonatal thoracoscopic procedures has been established to further enhance the quality of patient care. The creation of this team involved significant organizational and internal team challenges. Mandatory interdisciplinary collaboration agreements were vital in securing commitment not only from the team but also from departmental personnel who were not directly involved. The team promptly formed a cohesive unit based on mutual trust, and a structured routine was implemented, markedly improving the workflow of surgical procedures. When the establishment of a dedicated operating room team is desirable but impractical to execute, alternative strategies are available. As highly specialized institutions, tertiary children's hospitals already provide a high standard of care. Consequently, further "super specialization," such as the introduction of dedicated operating room teams, should be reserved for exceptional cases, particularly low-volume, high-risk procedures.