Background: The quality of surgical performance depends on the technical skills of the surgical team as well as on non-technical skills, including teamwork. The present study evaluated the impact of familiarity among members of the surgical team on morbidity in patients undergoing elective open abdominal surgery. Methods: A retrospective analysis was performed to compare the surgical outcomes of patients who underwent major abdominal operations between the first month (period I) and the last month (period II) of a 6-month period of continuous teamwork (stable dyads of one senior and one junior surgeon formed every 6months). Of 117 patients, 59 and 58 patients underwent operations during period I and period II, respectively, between January 2010 and June 2012. Team performance was assessed via questionnaire by specialized work psychologists; in addition, intraoperative sound levels were measured. Results: The incidence of overall complications was significantly higher in period I than in period II (54.2 vs. 34.5%; P=0.041). Postoperative complications grade <3 were significantly more frequently diagnosed in patients who had operations during period I (39.0 vs. 15.5%; P=0.007), whereas no between-group differences in grade ≥3 complications were found (15.3 vs. 19.0%; P=0.807). Concentration scores from senior surgeons were significantly higher in period II than in period I (P=0.033). Sound levels during the middle third part of the operations were significantly higher in period I (median above the baseline 8.85dB [range 4.5-11.3dB] vs. 7.17dB [5.24-9.43dB]; P<0.001). Conclusions: Team familiarity improves team performance and reduces morbidity in patients undergoing abdominal surgery
