The Byrne-Verasingam-Hasafa Method: A Novel Approach to Allocating Surgical Timing in Gynaecological Cases Incorporating Anaesthetic, Training, Logistical, and Patient Factors

Background: Accurate scheduling of complex gynaecological procedures remains challenging, with traditional skin‑to‑skin estimates frequently underestimating total theatre time. Inefficient scheduling contributes to overruns, underutilisation, and disruption of theatre teams. Methods: We retrospectively analysed 280 consecutive endometriosis surgeries performed by a single experienced surgeon at the North Mid Endometriosis Centre (NMEC), a tertiary referral and accredited training centre. Surgical time was allocated using the Byrne‑Verasingam‑Hasafa (BVH) method, which divides the operative day into 20‑minute surgical units (24 units=480 minutes). The BVH method incorporates anaesthetic induction, patient positioning, turnover, supervised trainee activity, exit logistics, and patient‑specific modifiers such as BMI and comorbidities. Primary outcome was predictive accuracy of surgical timing; secondary outcomes were list overruns and underutilisation. Results: The BVH method achieved 96% predictive accuracy (269/280 cases). Only five lists (1.8%) overran their allocation and three lists (1.1%) were underutilised. The inclusion of anaesthetic, logistical, and patient‑specific modifiers did not compromise accuracy. Example lists demonstrated that the BVH method can accommodate both mixed intermediate cases and single complex major procedures within a full day. Conclusions: The Byrne‑Verasingam‑Hasafa method is a simple, reproducible, and adaptable approach to surgical scheduling in gynaecology. By accounting for anaesthetic, logistical, training, and patient‑specific factors, it improves efficiency, reduces list overruns and underutilisation, and supports training without compromising throughput. The method is adaptable across surgical specialties and institutional contexts