Paper Title
“Twilight” Operating Sessions: Concept and Impact

Background: The efficient use of operating theatres is important to ensure optimum cost-benefit for the hospital and to reduce elective surgery waiting times. We introduced a concept of non-commissioned “Twilight” theatre session to reduce patient waiting list and mitigate consequences of non-availability of elective theatre time due to closure of an affiliated hospital theatre suite. Methods: A retrospective audit was performed during a 10-month period where Twilight session was implemented in our institution. Additionally, we included patients that were operated on 13 non-commissioned whole day theatre sessions on Saturdays during the same period. Results: A total of 223 cases were performed between July 2020 and April 2021. Most patients have American Society of Anesthesiologists (ASA) Class 2. Participating subspecialties were General Surgery, Orthopaedic surgery, Gynaecology, Urology, Plastic surgery and Dental surgery. A wide range of operations was performed in the Twilight session. No major complications were observed. Conclusion: Our study demonstrated the feasibility of conducting elective surgeries after hours with the advantage of reducing the hospital waiting time. Importantly, no major post-operative complications were reported. This model is a feasible and safe strategy to restore surgical activity impacted by the COVID-19 pandemic. Keywords - Operating Theatre, Surgery, Cost-effectiveness