Frozen Section Timeout: Pilot Study to Reconcile Margins Using 3D Resected Specimen and Defect Scans

Danielle A. Kapustin, Jun Yun, Vivian Su, Samuel J. Rubin, Ippolito Modica, Daniel Chung, Jun Fan, Mohemmed N. Khan, Raymond L. Chai, Michael Karasick, Scott Doyle, Margaret Brandwein-Weber, Mark L. Urken

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Objective: Opportunities exist to improve intraoperative communication and documentation of resection margin details. We instituted a “frozen section timeout” that centers around visualization of the paired resection specimen and surgical defect—facilitating effective, bidirectional exchange of information. Methods: We designed an interactive form for use during the “frozen section timeout” including annotated 3D virtual models of the resected specimen and surgical defect, plus a “line-item” table for primary and supplemental margin results. The “timeout” was conducted over a Zoom call between the operating room and frozen section laboratory. The form was simultaneously projected and discussed while all members of the surgical care team stopped activities. Nurses, co-surgeons, and all other members of the surgical team were encouraged to take part in this process. Results: Twenty-six frozen section timeouts were conducted during head and neck surgeries in the Department of Otolaryngology at Mount Sinai West Hospital. These timeouts were facilitated by the lead surgeon, and all other activities were halted to ensure that critical information was shared, documented, and agreed upon. During the timeout, the annotated specimen and defect scans were displayed, clearly demonstrating the at-risk margins and the corresponding location and breadth of supplemental margins harvested. Conclusion: Incorporating a frozen section timeout can improve intraoperative communication, increase transparency, and potentially eliminate uncertainty regarding margin status and tumor clearance. Visualization of at-risk margins and the corresponding location and breadth of supplemental margins promises an unprecedented level of documentation and understanding. This novel technique can establish a new and improved standard of care. Level of Evidence: NA Laryngoscope, 134:725–731, 2024.

Original languageEnglish
Pages (from-to)725-731
Number of pages7
JournalLaryngoscope
Volume134
Issue number2
DOIs
StatePublished - Feb 2024

Keywords

  • frozen sections
  • intraoperative communication
  • oncologic resection
  • surgical margins
  • surgical pathology
  • timeout

Fingerprint

Dive into the research topics of 'Frozen Section Timeout: Pilot Study to Reconcile Margins Using 3D Resected Specimen and Defect Scans'. Together they form a unique fingerprint.

Cite this