The effect of intraoperative distractions on severe technical events in laparoscopic bariatric surgery

Ayas, Suzan; Gordon, Lauren; Donmez, Birsen; Grantcharov, Teodor P.

doi:10.1007/s00464-020-07878-w

Cited by 9 publications

(6 citation statements)

References 32 publications

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“…Stress has been shown to impact adversely multiple facets critical to optimal performance [ 16 ]. Advancements in wearable technology can reduce barriers to observing stress during surgery.…”

Section: Discussionmentioning

confidence: 99%

The Utility of Video Recording in Assessing Bariatric Surgery Complications

Nedelcu

Carandina

Noe͏̈l

et al. 2022

JCM

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Introduction: Recording every procedure could diminish the postoperative complication rates in bariatric surgery. The aim of our study was to evaluate the correlation between recording every bariatric surgery and their postoperative analysis in relation to the early or late postoperative complications. Methods: Seven hundred fifteen patients who underwent a bariatric procedure between January 2018 and December 2019 were included in a retrospective analysis. There were: 589 laparoscopic sleeve gastrectomies (LSGs); 110 Roux-en-Y bypasses (RYGBs) and 16 gastric bands (LAGBs). The video recording was systematically used, and all patients were enrolled in the IFSO registry. Results: There were 15 patients (2.1%) with surgical postoperative complications: 5 leaks, 8 hemorrhages and 2 stenosis. Most complications were consequent to LSG, except for two, which occurred after RYGB. In four cases a site of active bleeding was identified. After reviewing the video, in three cases the site was correlated with an event which occurred during the initial procedure. Three out of five cases of leak following sleeve were treated purely endoscopically, and no potential correlated mechanism was identified. Two other possible benefits were observed: a better evaluation of the gastric pouch for the treatment of the ulcer post bypass and the review of one per operative incident. Two negative diagnostic laparoscopies were performed. The benefit of the systematic video recording was singled out in eight cases. All the other cases were completed by laparoscopy with no conversion. Conclusion: To record every bariatric procedure could help in understanding the mechanism of certain complications, especially when the analysis is performed within the team. Still, recording the procedure did not prevent the negative diagnostic laparoscopy, but it could play a significant role for the medico-legal aspect in the future.

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Section: Discussionmentioning

confidence: 99%

The Utility of Video Recording in Assessing Bariatric Surgery Complications

Nedelcu

Carandina

Noe͏̈l

et al. 2022

JCM

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“…Beyond oral instruction, extrinsic sounds such as music and equipment alarms are also associated with technical error. Ayas et al showed in gastric bypass surgery that machine alarms, which were one of the most common distractions, were associated with clinically relevant technical errors [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

Evolution of the digital operating room: the place of video technology in surgery

Youssef

Haram²,

Noël

et al. 2023

Langenbecks Arch Surg

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Purpose The aim of this review was to collate current evidence wherein digitalisation, through the incorporation of video technology and artificial intelligence (AI), is being applied to the practice of surgery. Applications are vast, and the literature investigating the utility of surgical video and its synergy with AI has steadily increased over the last 2 decades. This type of technology is widespread in other industries, such as autonomy in transportation and manufacturing. Methods Articles were identified primarily using the PubMed and MEDLINE databases. The MeSH terms used were “surgical education”, “surgical video”, “video labelling”, “surgery”, “surgical workflow”, “telementoring”, “telemedicine”, “machine learning”, “deep learning” and “operating room”. Given the breadth of the subject and the scarcity of high-level data in certain areas, a narrative synthesis was selected over a meta-analysis or systematic review to allow for a focussed discussion of the topic. Results Three main themes were identified and analysed throughout this review, (1) the multifaceted utility of surgical video recording, (2) teleconferencing/telemedicine and (3) artificial intelligence in the operating room. Conclusions Evidence suggests the routine collection of intraoperative data will be beneficial in the advancement of surgery, by driving standardised, evidence-based surgical care and personalised training of future surgeons. However, many barriers stand in the way of widespread implementation, necessitating close collaboration between surgeons, data scientists, medicolegal personnel and hospital policy makers.

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“…Although distractions are not always harmful (Sasangohar et al, 2012) and may be considered to be inherent to the OR, interruptions taking place during critical tasks that require focused attention may have undesirable effects. In a study of 60 laparoscopic surgeries, almost all severe adverse events were observed during critical tasks (Ayas et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

“…Audio-video recordings can provide more information as the researchers can rewind and re-watch. However, studies that utilize OR recordings are currently limited (e.g., Ayas et al, 2021;Jung et al, 2019;Savoldelli et al, 2010;Zheng et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

The Prevalence and Potential Effects of Distractions in General Surgery: A Mixed-Methods Study

Ayas

Donmez

Kazlovich

et al. 2022

Proceedings of the Human Factors and Ergonomics Society Annual

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Distractions can interfere with surgical tasks and may negatively impact task performance, surgery duration, and mood of surgical team members. A mixed-methods study was conducted to examine the prevalence and potential effects of distractions during general surgery, in particular during the surgical procedure and post-operative counts. An audio-video recording platform named the OR BlackBox® was used to record data from 40 surgical cases, which was in turn coded by multiple raters. Supporting qualitative data was collected through interviews with four OR staff members. The audio-video data revealed that distractions occurred on the average about every three minutes during the surgical procedure, and most frequently observed effect was distracted members not noticing other members’ requests. Twenty-nine of the cases had at least one changeover during the surgical procedure whereas overall four changeovers occurred during post-operative counts; in one of these cases the count was repeated, resulting in a delay of almost 15 minutes. Other distractions (OR traffic, communication, and others) were frequent both during the surgical procedure (M=0.39 per minute per case, SD=0.15) and post-operative counts (M=0.75 per minute per case, SD=0.44). The interviews were preliminary in nature and provided additional insights on the effects of OR distractions and potential mitigation strategies to inform future OR distraction research.

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The effect of intraoperative distractions on severe technical events in laparoscopic bariatric surgery

Cited by 9 publications

References 32 publications

The Utility of Video Recording in Assessing Bariatric Surgery Complications

The Utility of Video Recording in Assessing Bariatric Surgery Complications

Evolution of the digital operating room: the place of video technology in surgery

The Prevalence and Potential Effects of Distractions in General Surgery: A Mixed-Methods Study

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