Assessment of surgeon fatigue by surgical simulators

Tuwairqi, Khaled; Selter, Jessica; Sikder, Shameema

doi:10.2147/oas.s77711

Cited by 5 publications

(4 citation statements)

References 41 publications

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“…The impact of fatigue on surgeon’s surgical skills has been evaluated with the help of simulators, for example. Studies have shown a consistent decline in cognitive function, but in technical skills, the outcomes have been mixed ( 9 ). In some articles, it was shown that acute partial sleep deprivation can also have positive short-term effect on cognitive skills and therefore enhanced technical performance with increased objective alertness within complex tasks ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, after normal working hours, fatigue and sleep deprivation may increase the risk of adverse outcomes ( 8 ). There are several reports from different surgical fields reporting worse outcomes for surgeries performed during after-office hours or nighttime ( 9 ). However, patient-related demographics among those operated during nighttime are often different than among those operated during daytime.…”

Section: Introductionmentioning

confidence: 99%

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Nighttime Appendectomy is Safe and has Similar Outcomes as Daytime Appendectomy: A Study of 1198 Appendectomies

et al. 2020

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Introduction: Although it is controversial whether appendectomy can be safely delayed, it is often unnecessary to postpone operation as a shorter delay may increase patient comfort, enables quicker recovery, and decreases costs. In this study, we sought to study whether the time of day influences the outcomes among patients operated on for acute appendicitis. Materials and Methods: Consecutive patients undergoing appendectomy at Tampere University Hospital between 1 September 2014 and 30 April 2017 for acute appendicitis were included. Primary outcome measures were postoperative morbidity, mortality, length of hospital stay, and amount of intraoperative bleeding. Appendectomies were divided into daytime and nighttime operations. Results: A total of 1198 patients underwent appendectomy, of which 65% were operated during daytime and 35% during nighttime. Patient and disease-related characteristics were similar in both groups. The overall morbidity and mortality rates were 4.8% and 0.2%, respectively. No time categories were associated with risk of complications or complication severity. Neither was there difference in operation time and clinically significant difference in intraoperative bleeding. Patients undergoing surgery during night hours had a shorter hospital stay. In multivariate analysis, only complicated appendicitis was associated with worse outcomes. Discussion: We have shown that nighttime appendectomy is associated with similar outcomes than daytime appendectomy. Subsequently, appendectomy should be planned for the next available slot, minimizing delay whenever possible.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nighttime Appendectomy is Safe and has Similar Outcomes as Daytime Appendectomy: A Study of 1198 Appendectomies

et al. 2020

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“…Tomasko et al showed that, despite the increased sleepiness and workload of on-call surgeons working night shifts, this did not affect task completion and learning of new skills [ 57 ]. Others noted that tasks with lower cognitive demands were easily accomplished by sleep-deprived surgeons, whereas the performance of tasks with higher cognitive demands in such circumstances was more problematic as cognitive functions continuously declined with less sleep [ 58 , 59 ]. Reports on the effects of fatigue on surgical outcomes conflicted widely and left ample room for further investigation [ 30 , 60 , 61 , 62 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Daytime Versus Nighttime Laparoscopic Appendectomy in Children

et al. 2023

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Aim of the study: To evaluate the clinical outcomes and complication rate of laparoscopic appendectomy in children operated on during the daytime versus nighttime. Methods: A total of 303 children who underwent laparoscopic appendectomy for acute appendicitis between 1 January 2020 and 31 December 2022 were enrolled in this retrospective study. The patients were divided into two study groups. The first group consisted of the patients who underwent laparoscopic appendectomy during the day shift from 07:00–21:00 (n = 171), while the patients in the second group underwent laparoscopic appendectomy during the night shift from 21:00–07:00 (n = 132). The groups were compared for baseline clinical and laboratory data, treatment outcomes, and complications. The Mann–Whitney U test was used to compare continuous variables, while the Chi-square test was used to compare categorical variables. A two-sided Fisher’s exact test was used when the frequency of events in a certain cell was low. All p values less than 0.05 were considered significant. Results: The proportion of complicated appendicitis was almost the same in both patient groups (n = 63, 36.8% vs. n = 49, 37.1%, p = 0.960). Out of the total number of patients presenting during the daytime and nighttime, 11 (6.4%) and 10 (7.6%) developed a postoperative complication, respectively (p = 0.697). Additionally, rates of readmission (n = 5 (2.9%) vs. n = 2 (1.5%); p = 0.703), redo-surgery (n = 3 (1.7%) vs. n = 0; p = 0.260), conversion to open surgery (n = 0 vs. n = 1 (0.8%); p = 0.435) and length of hospital stay (n = 3 (IQR 1, 5) vs. n = 3 (IQR 2, 5); p = 0.368) did not differ significantly between daytime and nighttime appendectomies. The duration of the surgery was significantly shorter in patients presenting during the day than in those presenting at night (26 min (IQR 22, 40) vs. 37 min (31, 46); p < 0.001). Conclusions: Different shift times did not affect the treatment outcomes or complication rates for children receiving laparoscopic appendectomy.

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“…Indeed, the requirement to perform operations later in the day increases surgeon burden and fatigue. A previous study showed that fatigue impacts the surgeon's performance and surgical outcomes [4][5][6]. Adverse events and medical errors occur more frequently in fatigued physicians, and technical skills are also negatively in uenced by surgeon fatigue.…”

Section: Introductionmentioning

confidence: 99%

Surgical Case Order is an Independent Risk Factor for Postoperative Infection in Primary Total Knee Arthroplasty

Jia

Lü

et al. 2021

Preprint

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Background: Total knee arthroplasty is regarded as the most effective treatment for severe knee joint problems. Surgery case order influences operative outcomes according to previous studies. This study aims to evaluate the effect of surgical case order on operative outcomes for TKA.Methods: A retrospective study was conducted on 4,267 TKAs performed by three surgeons at our hospital from February 2008 to February 2018. Variables, such as surgical time, loss of blood, and hospitalization stay, were also recorded and analysed. Logistic regression was used to analyse every variable as a potential risk for a surgical site infection.Results: Of the 4267 cases in this cohort, 1531 TKAs were classified as first-round cases, 1194 TKAs were second-round cases, 913 TKAs were third-round cases, 490 TKAs were fourth-round cases, and 139 were fifth-round or later cases. The mean operating time was shorter in intermediate cases (P< 0.01). Perioperative adverse events were increased in later surgical cases (P< 0.01). Later case order (OR= 1.29 [95% CI: 1.17–1.56], P<0.01) was a significant risk factor for severe arthroplasty complications. The operative time and length of stay were increased for cases performed later in the day. However, blood loss is not statistically associated with case order. Conclusions: Surgical case order is an independent risk factor for surgical infection. Significantly increased operative time and longer LOS were noted for third-round or later TKA cases. Our results identify potentially modifiable risk factors contributing to infection rates in TKA, and cases operated on later in the day in the same room were more likely to have a higher infection risk.

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Assessment of surgeon fatigue by surgical simulators

Cited by 5 publications

References 41 publications

Nighttime Appendectomy is Safe and has Similar Outcomes as Daytime Appendectomy: A Study of 1198 Appendectomies

Nighttime Appendectomy is Safe and has Similar Outcomes as Daytime Appendectomy: A Study of 1198 Appendectomies

Clinical Outcomes of Daytime Versus Nighttime Laparoscopic Appendectomy in Children

Surgical Case Order is an Independent Risk Factor for Postoperative Infection in Primary Total Knee Arthroplasty

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