In the operating room, patients often assume that the surgeon who begins their procedure will be the same one who finishes it. While this is true in most cases, there are situations where a handover between surgeons occurs during surgery. When this occurs, it must be managed with careful planning to ensure patient safety and continuity of care. Understanding the reasons behind a surgeon handover can help demystify the process and reassure patients about the quality and safety of their surgical experience.
Communication is a critical component of any surgical handover. Much like a relay race, where the baton must be passed smoothly for success, surgical handovers involve a structured transfer of information. Surgeons use checklists, verbal briefings, and written records to ensure that nothing is overlooked. Hospitals have systems of communication to provide information about the patient’s condition, the steps already taken in the procedure, and what remains to be done. Anesthesiologists and nursing staff also help maintain continuity and provide important context to the incoming surgeon.
Among the most common reasons for a surgeon handover during surgery is a particularly long and/or complex procedure. Some surgeries, particularly those involving major organs or complex reconstructions, can last many hours. Even the most experienced and skilled surgeons have physical and mental limits. Prolonged operations can lead to fatigue, which may affect concentration, judgment, and precision. To prevent these issues, a second surgeon may take over partway through the procedure, ensuring that each phase is performed with optimal attention and focus. This kind of planned handover is not a sign of weakness or error, but a proactive step to maintain high standards of care.
Another reason for a surgeon handover could be the involvement of different specialties. Certain cases require collaboration among specialists who bring unique expertise. For example, in a cancer surgery that involves both the removal of a tumor and a complex reconstruction, one surgeon may perform the tumor resection while another, perhaps a plastic or reconstructive surgeon, completes the reconstruction. This division of tasks allows each phase of the operation to be handled by the most qualified professional for that specific component.
Occasionally, unexpected events may necessitate a handover. A surgeon could experience a sudden illness, an emergency in another case, or an issue unrelated to the surgery that makes it unsafe for them to continue. In such cases, another qualified surgeon steps in to complete the procedure.
Teaching hospitals, where surgical training occurs, have reasons to utilize surgeon handovers more often than other surgical facilities, as senior surgeons often supervise residents or fellows who perform parts of the operation under close guidance. If a training surgeon begins a procedure but reaches a point requiring a higher level of expertise, the attending surgeon may take over. Alternatively, if a shift change occurs during a longer operation, another equally qualified surgical team member may assume the lead. These transitions are standard practice in academic settings and are designed to support both patient safety and the training of future surgeons.
For patients, it is important to know that surgeon handovers are not uncommon and do not indicate a problem. Instead, they reflect a collaborative approach to complex care, prioritizing safety, expertise, and outcomes. If a handover is planned or expected, patients are typically informed in advance. Even when unplanned, the system is designed to minimize risk and ensure a seamless transition. Ultimately, every surgical decision, including who performs which part, is made with the patient’s best interest in mind.