A quantitative study of disruption in the operating room during laparoscopic antireflux surgery

Zheng, Bin; Martinec, Danny V.; Cassera, Maria A.; Swanström, Lee L.

doi:10.1007/s00464-008-0017-7

Cited by 76 publications

(66 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They are consistent with findings that information exchanges in the OR often take place in less than ideal conditions [7][8][9], thus potentially causing additional stress to the operating surgeon, which in turn impacts negatively on teamworking and team cohesion [10,11]. A novel aspect of the present study is the approach to addressing these problems that the physicians in our sample proposed: skills training and standardization, in the form of protocols that everyone is aware of and uses, as well as in the form of IT systems.…”

Section: Discussionsupporting

confidence: 89%

“…In general surgical cases (open and laparoscopic), typically lasting between 30 min and 4 h, OR personnel have been found to experience an average of 3-4 distractions in their communication [7]. Another study found that disruptive communications were the most frequent cause of distraction in laparoscopic antireflux surgery [8]. OR personnel are aware that their work is frequently disrupted, with particular impact on the communications among them [9][10][11].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Information needs in operating room teams: what is right, what is wrong, and what is needed?

et al. 2010

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

Information needs in operating room teams: what is right, what is wrong, and what is needed?

et al. 2010

View full text Add to dashboard Cite

show abstract

“…The findings of the two observers for these six procedures were compared, and the interobserver agreement was calculated (function incorporated in The Observer Ò XT 11.5 software). If satisfactory interobserver agreement would be achieved, the remaining procedures could be annotated by the two observers separately (randomly allocated and analyzed in a non-chronological random order) [5,23].…”

Section: Methodsmentioning

confidence: 99%

“…Studies describing surgical processes were generally based on live observation in the OR; video observation has only been used infrequently [6,8,22,23]. Nevertheless, video registration is deemed superior since it is not limited by the capacity of an observer, cause-and-effect relationships are better analyzable, and the Hawthorne effect (i.e., the awareness of being observed alters the way a person behaves) is minimized [6,7,24,25].…”

mentioning

confidence: 99%

Surgical Flow Disturbances in Dedicated Minimally Invasive Surgery Suites: An Observational Study to Assess Its Supposed Superiority Over Conventional Suites

Blikkendaal

Driessen

Rodrigues

et al. 2016

Journal of Minimally Invasive Gynecology

View full text Add to dashboard Cite

Background Minimally invasive surgery (MIS) is frequently compromised by surgical flow disturbances due to technology-and equipment-related failures. Compared with MIS in a conventional cart-based OR, performing MIS in a dedicated integrated operating room (OR) is supposed to be beneficial to patient safety. The aim of this study was to compare a conventional OR with an integrated OR with regard to the incidence and effect of equipmentrelated surgical flow disturbances during an advanced laparoscopic gynecological procedure [laparoscopic hysterectomy (LH)]. Methods Using video recording, 40 LHs performed between November 2010 and April 2012 (20 in a conventional cart-based OR and 20 in an integrated OR) were analyzed by two different observers. Outcome measures were the number, duration and effect (on a seven-point ordinal scale) of the surgical flow disturbances (e.g., malfunctioning, intraoperative repositioning, setup device). Results A total of 103 h and 45 min was observed. The interobserver agreement was high (kappa .85, p \ .001). Procedure time was not significantly different (NS) [conventional OR vs. integrated OR, minutes ± standard deviation (SD), mean 161 ± 27 vs. 150 ± 34]. A total of 1651 surgical flow disturbances were observed (mean ± SD per procedure 40.8 ± 19.4 vs. 41.8 ± 15.9, NS). The mean number of surgical flow disturbances per procedure with regard to equipment was 6.3 ± 3.7 versus 8.5 ± 4.0, NS. No clinically relevant differences in the mean effect of these disturbances on the surgical flow between the two OR setups were observed. Conclusions Performing LH in an integrated OR did not reduce the number of surgical flow disturbances nor the effect of these disturbances. Furthermore, in the integrated OR, repositioning of the monitors was a frequent and timeconsuming source of disturbance. In order to maintain the high standard of surgical safety, the entire surgical team has to be aware that by performing surgery in an integrated OR different potential source for disruption arise.

show abstract

“…Several tools and methodologies have been developed and applied in surgery to quantify interruptions in surgical procedures (Zheng et al 2008;Parker et al 2010;Sutton et al 2010;Blocker et al 2010). Parker et al (2010) developed a surgical flow disruption tool that categorizes disruption events into 1) technical factors, 2) environmental factors, 3) technology and instruments, 4) training and procedures, 5) teamwork, and 6) others.…”

Section: Introductionmentioning

confidence: 99%

Gaze and viewing patterns in microsurgery

Cha

Kasten

et al. 2014

Proceedings of the Human Factors and Ergonomics Society Annual

View full text Add to dashboard Cite

Gaze disruptions in surgery have been associated with suboptimal surgical workflow, and human factor tools have been developed to quantify these events in cardiovascular and laparoscopic surgeries. Disruptions to workflow may be a particular concern in microsurgery because looking away from the microscope can cause the surgeon to lose view of delicate and precise tasks occurring at the surgical site. However, these viewing patterns in microsurgery have not been investigated. The purpose of this study is to quantify the gaze and viewing patterns during the microsurgery procedure. Event-based task analysis was performed for 14 surgeons performing microsurgery. Results found that average length of procedure was 70±33 minutes. Surgeons were observed to primarily interact with microscope 83±9% during microsurgery. Surgeons were observed to look away from the microscope in order to examine the tool area, patient site, and rest. Frequency of gaze away from the microscope was observed to be 11 disruptions per 10 minutes. Observed gaze demands of microsurgery and the limited opportunity for rests may impact surgeon performance and their risk for musculoskeletal fatigue.

show abstract

A quantitative study of disruption in the operating room during laparoscopic antireflux surgery

Cited by 76 publications

References 15 publications

Information needs in operating room teams: what is right, what is wrong, and what is needed?

Information needs in operating room teams: what is right, what is wrong, and what is needed?

Surgical Flow Disturbances in Dedicated Minimally Invasive Surgery Suites: An Observational Study to Assess Its Supposed Superiority Over Conventional Suites

Gaze and viewing patterns in microsurgery

Contact Info

Product

Resources

About