Disruption Driving Innovation: Optimising Efficiency in Functional Neurosurgery.

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

Profile and outcomes of Parkinson's disease deep brain stimulation in a public tertiary center in Brazil: retrospective cohort.Arquivos de neuro-psiquiatria · 2026
Observational
A neutrosophic explainable AI framework for modeling uncertainty in immersive stereotactic neurosurgical simulation.Frontiers in neurology
Article

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ludvic ZrinzoUnit of Functional Neurosurgery, Department of Neurosurgery, National Hospital of Neurology and Neurosurgery, London, UK.

Harith AkramUnit of Functional Neurosurgery, Department of Neurosurgery, National Hospital of Neurology and Neurosurgery, London, UK.

Jonathan HyamUnit of Functional Neurosurgery, Department of Neurosurgery, National Hospital of Neurology and Neurosurgery, London, UK.

Joseph Candelario-MckeownUnit of Functional Neurosurgery, Department of Neurosurgery, National Hospital of Neurology and Neurosurgery, London, UK.

Ranjit RangnekarUnit of Functional Neurosurgery, Department of Neurosurgery, National Hospital of Neurology and Neurosurgery, London, UK.

Ashley NwanzeGeneral Management, Department of Neurosurgery, National Hospital of Neurology and Neurosurgery, London, UK.

San San XuUnit of Functional Neurosurgery, Department of Neurosurgery, National Hospital of Neurology and Neurosurgery, London, UK.

Thomas FoltynieUnit of Functional Neurosurgery, Department of Neurosurgery, National Hospital of Neurology and Neurosurgery, London, UK.

Patricia LimousinUnit of Functional Neurosurgery, Department of Neurosurgery, National Hospital of Neurology and Neurosurgery, London, UK.

Marie T KrügerUnit of Functional Neurosurgery, Department of Neurosurgery, National Hospital of Neurology and Neurosurgery, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRising NHS waiting lists are a major problem following the COVID-19 pandemic. In our institution, surgical waiting time for elective functional neurosurgical procedures, such as deep brain stimulation (DBS) and radiofrequency ablation (RFA), reached >1.5 years by the end of 2022. During 2023, reduced operating room availability, intraoperative MRI (iMRI) suite closure for refurbishment, and ongoing strikes threatened to increase waiting times further.

methodsOur previous surgical workflow for DBS and RFA procedures was examined. Several aspects were identified, and changes implemented to increase efficiency. Procedure numbers, waiting times, lead placement accuracy, and complication rates before and after these changes were compared.

resultsPrior to 2023, an average of 0.8 new procedures were performed per surgical list. Introduction of a new workflow in 2023 allowed an average of 1.6 new procedures per surgical list (100% increase in productivity). In 2023, 95 DBS and 31 RFA procedures were performed on 79 surgical lists. This represents a 52% increase over "pre-pandemic" activity in 2019 (74 DBS, 9 RFA) on 102 available surgical lists. Mean (SD) targeting accuracy (0.8 [0.4] mm) was comparable to previous years (0.9[0.3] mm). In 2023, there were no infections requiring hardware removal and only one asymptomatic haemorrhage following an RFA procedure. The surgical waiting time was reduced from >1.5 years to <4 months by the end of 2023.

conclusionChanges in surgical workflow, with neurosurgeons working in parallel, maximise surgical efficiency and productivity, significantly increasing the number of DBS and RFA procedures without compromising accuracy and safety.

introductionRising NHS waiting lists are a major problem following the COVID-19 pandemic. In our institution, surgical waiting time for elective functional neurosurgical procedures, such as deep brain stimulation (DBS) and radiofrequency ablation (RFA), reached >1.5 years by the end of 2022. During 2023, reduced operating room availability, intraoperative MRI (iMRI) suite closure for refurbishment, and ongoing strikes threatened to increase waiting times further.

methodsOur previous surgical workflow for DBS and RFA procedures was examined. Several aspects were identified, and changes implemented to increase efficiency. Procedure numbers, waiting times, lead placement accuracy, and complication rates before and after these changes were compared.

resultsPrior to 2023, an average of 0.8 new procedures were performed per surgical list. Introduction of a new workflow in 2023 allowed an average of 1.6 new procedures per surgical list (100% increase in productivity). In 2023, 95 DBS and 31 RFA procedures were performed on 79 surgical lists. This represents a 52% increase over "pre-pandemic" activity in 2019 (74 DBS, 9 RFA) on 102 available surgical lists. Mean (SD) targeting accuracy (0.8 [0.4] mm) was comparable to previous years (0.9[0.3] mm). In 2023, there were no infections requiring hardware removal and only one asymptomatic haemorrhage following an RFA procedure. The surgical waiting time was reduced from >1.5 years to <4 months by the end of 2023.

conclusionChanges in surgical workflow, with neurosurgeons working in parallel, maximise surgical efficiency and productivity, significantly increasing the number of DBS and RFA procedures without compromising accuracy and safety.

Indexed as

COVID-19Deep Brain StimulationInventionsNeurosurgical ProceduresHumansOperating RoomsRadiofrequency AblationWaiting ListsWorkflowDeep brain stimulationOptimising workflowRadiofrequency ablationSafety and efficiencySurgical waiting time