A systematic examination of preoperative surgery warm-up routines

Abstract

Background: Recent evidence indicates that a preoperative warm-up is a potentially useful tool in facilitating performance. But what factors drive such improvements and how should a warm-up be implemented? Methods:In order to address these issues, we adopted a two-pronged approach: (i) we conducted a systematic review of the literature to identify existing studies utilizing preoperative simulation techniques; (ii) we performed task analysis to identify the constituent parts of effective warm-ups. We identified five randomised control trials, four randomised crossover trials and four case series. The majority of these studies reviewed surgical performance following preoperative simulation relative to performance without simulation.Results: Four studies reported outcome measures in real patients and the remainder reported simulated outcome measures. All but one of the studies found that preoperative simulation improves operative outcomes-but this improvement was not found across all measured parameters. Whilst the reviewed studies had a number of methodological issues, the global data indicate that preoperative simulation has substantial potential to improve surgical performance. Analysis of the task characteristics of successful interventions indicated that the majority of these studies employed warm-ups that focused on the visual motor elements of surgery. However, there was no theoretical or empirical basis to inform the design of the intervention in any of these studies. Conclusions:There is an urgent need for a more rigorous approach to the development of Ôwarm-upÕ routines if the potential value of preoperative simulation is to be understood and realised. We propose that such interventions need to be grounded in theory and empirical evidence on human motor performance.

Operating list composition and surgical performance

“…One limitation of the present analyses is that the data cannot address the issue of the mechanisms of performance facilitation. However, the results do triangulate with existing empirical work showing that warm up reduces operating times and task switching increases completion times 25 . This indicates a need to explore these areas through further research.…”

High-Performance Virtual Reality Volume Rendering of Original Optical Coherence Tomography Point-Cloud Data Enhanced With Real-Time Ray Casting

“…Next, we wanted to explore whether the tool could be used to augment intraoperative performance (e.g., as a preoperative simulation tool). 6 , 7 Therefore, we asked whether the ophthalmologists in our sample felt that the tool could help them anticipate potential problems and take appropriate action. Here, 14% strongly agreed and 46.9% agreed that it could be useful in this regard, 34.69% were ambivalent, and 4% disagreed.…”

“…Major progress has been made in virtual reality (VR) technology (defined as systems that support skilled sensorimotor interactions with computer generated information in three-dimensional [3D] space) 1 in recent years. While the entertainment (and specifically gaming) industry has been driving much of the progress, these developments are expected to transform the medical field and are increasingly being used to provide clinicians with environments that augment their training, 2 – 5 facilitate operative planning, 6 , 7 and support clinical decision making. 8 – 11 …”

A review of simulation applications in temporal bone surgery

“…An important, clinically significant role of VR simulation is in engaging with the patient's imaging studies in the same context as would be done during surgery. Virtual surgical rehearsal allows surgeons to better understand the anatomy, extent of pathology, and difficulty of access or exposure they are likely to encounter in the operating room for a given patient, improving both surgeon confidence and dissection performance . Integration of a computational model of a clinically relevant patient outcome can allow the surgeon to assess the potential impact on patients with each simulation run.…”