When team members collaborate, they gain valuable opportunities to understand each other's responsibilities, capabilities, and approaches to handling crises.1 Team experiences enables team members to develop skills for sharing knowledge and fostering collaboration. Recently, researchers have been using the concept of team familiarity score (TFS) to depict previous experience among team members towards a particular team task.2,3 Evidence from diverse fields such as software development, police training, and resource management indicates that a higher level of team familiarity may lead to enhanced team performance.4, 5, 6 A growing body of research in the surgical field also underscores the significance of familiarity within operating teams.7, 8, 9, 10

In our earlier study, we reported a negative correlation (r = −0.25, P < 0.01) between TFS and surgical procedure time in laparoscopic operations; with every 1% increase in TFS, PT decreases by about 0.24% (p < 0.001).11 The above findings were obtained from a dataset including 360 cases of laparoscopic anti-reflex operations.11 Cases included were relatively homogeneous and completed only with the laparoscopic technique.

In this study, we aim to evaluate the effectiveness of utilizing the TFS to assess team performance, drawing from a larger dataset comprising various general surgical procedures performed using both open and laparoscopic techniques. We believe that teams are more likely to achieve significant improvements in surgical outcomes for complex cases compared to simpler ones. As basic surgical cases have shorter PT, leaving limited room for time-saving improvements through team management, the impact of surgical team familiarity on procedure time may therefore be more evident in complex surgical cases. We hypothesize that team familiarity will contribute significantly to the enhancement of team performance in complex surgical cases, rather than in basic and medium cases, as measured by surgical outcomes including procedure time (PT), length of hospital stays (LOS), and surgical cost (COST).