Super Saturday in surgery to tackle waiting lists

16 April 2025 - Neurosurgical team working in new ways to treat patients quickly

The neurosurgical team at King’s College Hospital is trialling a new way of working to reduce the time patients are waiting for routine surgery.

High intensity theatre (HIT) lists are being tested on Saturdays to safely treat a greater number of patients with neck and spinal problems.

Recently, the team carried out eight procedures in one day compared to an average of 2.5 cases on a standard single list.

HIT lists focus on one type of procedure at a time, allowing for streamlined preparation, and maximising the number of patients being treated in one day.

During a HIT list, there are increased numbers of anaesthetic, surgical and theatre staff to ensure patients are prepped and ready for their procedure, reducing the amount of non-operating time for the surgeon.

Two operating theatres along with three multi-disciplinary teams work to enable the surgeon to go between cases, allowing more cases to be carried out in the same time period.

Mr Gordan Grahovac, Consultant Neurosurgeon at King’s College Hospital, who has been operating during a HIT list, said: “Careful planning to select the most suitable patients, coupled with streamlined processes, is key to the success of HIT lists.

“We are currently looking at all areas of the patient’s journey, seeing what works well, and where we need to make changes to safely improve efficiency. This allows us, as surgeons, to spend more time operating and less time carrying out non-operative tasks.

“As well as refining hospital processes, we are also looking at patient education and how we can support those undergoing surgery to make a swift post-operative recovery.

“At King’s, we have an Enhanced Recovery Team working with patients to ensure they are as fit and healthy as possible before surgery – supporting them to eat well and exercise, as well as give up or reduce smoking and alcohol consumption – and mobilise quickly after surgery.

“Research has shown that the earlier a person gets out of bed and starts walking, eating and drinking after having an operation, the shorter their recovery time will be.”

The HIT list procedures carried out were Anterior Cervical Discectomy and Fusion (ACDF) surgery on patients experiencing pressure on the spinal cord or nerves causing pain, tingling, numbness, or weakness in the upper limbs, and laminectomies to treat compressed nerves in the lower spine, resulting from a range of conditions including slipped discs, sciatica and spinal injuries.

Of the eight patients operated on, six were well enough to be discharged the following day, and the remaining two the day after.