Time Savings and Surgery Task Load Reduction in Open Intraperitoneal Onlay Mesh Fixation Procedure

Abstract

Background. This study assessed the reduction in surgeon stress associated with savings in procedure time for mechanical fixation of an intraperitoneal onlay mesh (IPOM) compared to a traditional suture fixation in open ventral hernia repair. Study Design. Nine general surgeons performed 36 open IPOM fixation procedures in porcine model. Each surgeon conducted two mechanical (using ETHICON SECURESTRAPTM Open) and two suture fixation procedures. Fixation time was measured using a stopwatch, and related surgeon stress was assessed using the validated SURG-TLX questionnaire. T-tests were used to compare between-group differences, and a two-sided 95% confidence interval for the difference in stress levels was established using nonparametric methodology. Results. The mechanical fixation group demonstrated an 89.1% mean reduction in fixation time, as compared to the suture group (p < 0.00001). Surgeon stress scores measured using SURG-TLX were 55.5% lower in the mechanical compared to the suture fixation group (p < 0.001). Scores in five of the six sources of stress were significantly lower for mechanical fixation. Conclusions. Mechanical fixation with ETHICON SECURESTRAPTM Open demonstrated a significant reduction in fixation time and surgeon stress, which may translate into improved operating efficiency, improved performance, improved surgeon quality of life, and reduced overall costs of the procedure.

Comparison of economic and clinical outcomes between patients undergoing laparoscopic bariatric surgery with powered versus manual endoscopic surgical staplers

“…Surgeons agree that improved endoscopic linear stapling device stability is a critical component of surgery and is likely to result in more frequent positive surgical outcomes 33 . This could potentially reduce surgery stress based on the interesting theoretical framework of the biopsychosocial model (BPSM) of challenge and threat 34 that has been applied to explain differences in stress reaction to surgical device use 35 . The framework is predicated upon the surgeon's evaluation of the demands of a procedure compared against the possession or availability of necessary resources to cope effectively with such demands 34 .…”

Preclinical evaluation of the effect of the combined use of the Ethicon Securestrap^&reg; Open Absorbable Strap Fixation Device and Ethicon Physiomesh&trade; Open Flexible Composite Mesh Device on surgeon stress during ventral hernia repair

“…These results support the results observed in a previous study, which demonstrated reductions in surgeon stress measured by SURG-TLX and faster fixation times. 15 …”

“…Surgical task load was measured using the surgical task load index (SURG-TLX), a validated self-reported questionnaire that measures intraoperative mental stress and workload by evaluating six different dimensions: mental demands, physical demands, temporal demands, task complexity, situation stress, and distractions. 14 , 15 …”

“…This study expanded on an earlier work performed using a similar simulated hernia repair model by measuring the levels of cortisol and alpha amylase in the saliva of surgeons to evaluate surgeon stress. 15 Previous studies have demonstrated that cortisol correlates with hypothalamic–pituitary–adrenal (HPA) activity, which is associated with lack of perceived control, withdrawal, and distress; whereas, salivary alpha amylase (sAA) correlates with autonomic nervous system (ANS) arousal, an indicator of perceived control, cognitive effort, and an identified need to mobilize existing skills and strategies to solve problems. 16 , 17 Using a mechanical strap fixation device in conjunction with a preformed skirted mesh product was predicted to reduce surgical time and surgeon stress levels compared with traditional suture fixation performed using a standard flat mesh, resulting in reduced HPA activity and ANS arousal.…”

MECHANICAL AND MANUAL ANASTOMOSES IN COLORECTAL SURGERY (review)

“…Roy S. и соавт. (2015) [62] изучали снижение хирургического стресса, связанного с экономией времени при использовании механических сшивающих устройств по сравнению с ручными швами. Механические методы показали сокращение времени операции на 89,1 % по сравнению с ручным швом (p<0,00001), хирургический стресс был на 55 %, соответственно, ниже при его оценке по SURGTLX.…”