• Andre Roncon Dias.
• Instituto do Câncer, Universidade de São Paulo, São Paulo, SP, Brasil.
• Rev Assoc Med Bras (1992). 2020 Nov 1; 66 (11): 1548-1552.

IntroductionIn the future, surgery will be centralized in hospitals with the best value (excellent results with reduced cost). High-performance teams will be required; however, available data concerning the specific abilities necessary to build and manage them are poor.ObjectivesShare the set of competencies and skills established to build and lead a high-performance general surgery team.MethodsIn November 2012, a general surgery team started its activities at a tertiary hospital in Sao Paulo, Brasil. The model consisted of high volume performed by a small team. Experienced surgeons, motivated, and with technical and moral excellence were selected. A sense of unity was created and goals were shared. Complex cases were discussed daily and a prospective database to follow outcomes was established. The payment value was above the market.ResultsIn 6 years and 4 months, 11,006 surgical procedures were performed (8,597 electives and 2,409 in an urgent setting). Cholecystectomy was the most common procedure (4,101; being 3,676 electives), followed by inguinal hernioplasty (n: 1,827) and appendectomy (n: 925). A total of 449 elective oncologic procedures were performed. The surgical site infection rate in clean procedures was 0.12%, 80 patients required re-do surgery (2.4% in an urgent setting and 0.2% of the electives). There were 22 postoperative deaths (0.66% for urgent and 0.07% for electives), 5 of the 6 deaths in elective patients were in oncologic cases.ConclusionA competent surgical team, inserted in a model that favors performance and values the individual can deliver high volume with exceptional results.

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