Evidence that surgical performance predicts clinical outcomes

Goldenberg, Mitchell

doi:10.1007/s00345-019-02857-w

Cited by 7 publications

(7 citation statements)

References 23 publications

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“…approaches have emerged as a potential alternative in recent years [18]. Expectedly, multiple studies have shown that training generally contributes to a reduction in patient morbidity and mortality from interventional procedures [19][20][21][22]. Hseino et al [23] and Patel et al [24], among others, demonstrated a positive learning curve for model-based training of procedures such as treatment of the aorta, renal arteries, the carotid artery, and intracranial vessels.…”

Section: Plos Onementioning

confidence: 99%

Training for endovascular therapy of acute arterial disease and procedure-related complication: An extracorporeally-perfused human cadaver model study

Hartung,

Augustin,

Grunz

et al. 2024

PLoS ONE

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Purpose The aim of this study was to evaluate the usability of a recently developed extracorporeally-perfused cadaver model for training the angiographic management of acute arterial diseases and periprocedural complications that may occur during endovascular therapy of the lower extremity arterial runoff. Materials and methods Continuous extracorporeal perfusion was established in three fresh-frozen body donors via inguinal and infragenicular access. Using digital subtraction angiography for guidance, both arterial embolization (e.g., embolization using coils, vascular plugs, particles, and liquid embolic agents) and endovascular recanalization procedures (e.g., manual aspiration or balloon-assisted embolectomy) as well as various embolism protection devices were tested. Furthermore, the management of complications during percutaneous transluminal angioplasty, such as vessel dissection and rupture, were exercised by implantation of endovascular dissection repair system or covered stents. Interventions were performed by two board-certified interventional radiologists and one resident with only limited angiographic experience. Results Stable extracorporeal perfusion was successfully established on both thighs of all three body donors. Digital subtraction angiography could be performed reliably and resulted in realistic artery depiction. The model allowed for repeatable training of endovascular recanalization and arterial embolization procedures with typical tactile feedback in a controlled environment. Furthermore, the handling of more complex angiographic devices could be exercised. Whereas procedural success was be ascertained for most endovascular interventions, thrombectomies procedures were not feasible in some cases due to the lack of inherent coagulation. Conclusion The presented perfusion model is suitable for practicing time-critical endovascular interventions in the lower extremity runoff under realistic but controlled conditions.

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Section: Plos Onementioning

confidence: 99%

Training for endovascular therapy of acute arterial disease and procedure-related complication: An extracorporeally-perfused human cadaver model study

Hartung,

Augustin,

Grunz

et al. 2024

PLoS ONE

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“…Finally, Goldberg highlighted several studies from multiple surgical specialties and procedures that have confirmed the association between surgeon skill, measured in varying methods, and clinically significant patient outcomes [1]. Establishing this relationship between surgeon performance and patient outcomes asserts the value and importance of surgeon assessment in clinical and training environments.…”

mentioning

confidence: 93%

“…Surgeon performance directly impacts patient outcomes [1]. Training and assessment go hand in hand-one cannot exist without the other.…”

mentioning

confidence: 99%

Pillars to improve patient outcomes: training and assessment methods for surgery

Hung

Ghazi

2020

World J Urol

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“…In the United States alone, surgical complications resulted in 32,600 deaths, 2.4 million extra days in hospitals, and USD 9.3B of costs in a year [ 2 ]. Therefore, it is essential to ensure that surgeons and surgical residents acquire sufficient surgical skills prior to performing surgeries in operating rooms because unskilled surgical performance is associated with increased surgical complications [ 3 ]. Differing from the assessment of medical knowledge via written/oral examinations, the assessment of technical hands-on surgical skills can be more challenging [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Motion Smoothness-Based Assessment of Surgical Expertise: The Importance of Selecting Proper Metrics

Aghazadeh

Zheng

Tavakoli

et al. 2023

Sensors

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The smooth movement of hand/surgical instruments is considered an indicator of skilled, coordinated surgical performance. Jerky surgical instrument movements or hand tremors can cause unwanted damages to the surgical site. Different methods have been used in previous studies for assessing motion smoothness, causing conflicting results regarding the comparison among surgical skill levels. We recruited four attending surgeons, five surgical residents, and nine novices. The participants conducted three simulated laparoscopic tasks, including peg transfer, bimanual peg transfer, and rubber band translocation. Tooltip motion smoothness was computed using the mean tooltip motion jerk, logarithmic dimensionless tooltip motion jerk, and 95% tooltip motion frequency (originally proposed in this study) to evaluate their capability of surgical skill level differentiation. The results revealed that logarithmic dimensionless motion jerk and 95% motion frequency were capable of distinguishing skill levels, indicated by smoother tooltip movements observed in high compared to low skill levels. Contrarily, mean motion jerk was not able to distinguish the skill levels. Additionally, 95% motion frequency was less affected by the measurement noise since it did not require the calculation of motion jerk, and 95% motion frequency and logarithmic dimensionless motion jerk yielded a better motion smoothness assessment outcome in distinguishing skill levels than mean motion jerk.

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Evidence that surgical performance predicts clinical outcomes

Cited by 7 publications

References 23 publications

Training for endovascular therapy of acute arterial disease and procedure-related complication: An extracorporeally-perfused human cadaver model study

Training for endovascular therapy of acute arterial disease and procedure-related complication: An extracorporeally-perfused human cadaver model study

Pillars to improve patient outcomes: training and assessment methods for surgery

Motion Smoothness-Based Assessment of Surgical Expertise: The Importance of Selecting Proper Metrics

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