Surgeons don’t know what they don’t know about the safe use of energy in surgery

Abstract

Many surgeons have knowledge gaps in the safe use of widely used energy-based devices. A formal curriculum in this area can address this gap and contribute to increased safety.

Fundamental Use of Surgical Energy (FUSE): An Essential Educational Program for Operating Room Safety

“…These SAGES leaders did not know how to correctly handle a fire on the patient (31%), could not identify the electrosurgical device least likely to interfere with a pacemaker (31%), did not know that thermal injury could extend beyond the jaws of a bipolar instrument (13%), and thought a dispersive electrode should be cut to fit a child (10%). 33,34 Results among course participants and surgical trainees were similar to each other. 33,34 This finding demonstrated that surgical "experts" do not necessarily have greater knowledge of energy-based surgical devices compared with nonexpert surgeons or even junior trainees.…”

“…33,34 Results among course participants and surgical trainees were similar to each other. 33,34 This finding demonstrated that surgical "experts" do not necessarily have greater knowledge of energy-based surgical devices compared with nonexpert surgeons or even junior trainees. These results highlight the need to educate trainees and surgeons in the knowledge and understanding of safe and appropriate use of energy-based surgical devices.…”

A novel approach to assess minimally invasive surgical device failure utilizing adverse event outcome severity and design complexity.

“…Since many surgeons are not aware of the tissue handling characteristics and limitations of new or reengineered devices, the knowledge gap can impact the clinical outcome of operations (Feldman, Fuchshuber et al 2012, Feldman, Brunt et al 2013, Sankaranarayanan, Resapu et al 2013, Chekan and Whelan 2014. Adverse events have been shown to be attributed to both user error as well as device-related errors.…”

“…Rapid technological advancement has allowed the development of highly complex, intricate medical devices, which is especially notable in the evolution of devices used for minimally invasive surgery (MIS) (Janetschek, Bagheri et al 2003, Feldman, Fuchshuber et al 2012, Chekan and Whelan 2014. MIS has become more applicable to an increasing number and variety of procedures and in many cases has become the preferred technique over open procedures (Belli, Fantini et al 2006, Hu, Gu et al 2009, Zingg, McQuinn et al 2009, Biere, van Berge Henegouwen et al 2012, Swanson, Meyers et al 2012.…”

“…MIS has become more applicable to an increasing number and variety of procedures and in many cases has become the preferred technique over open procedures (Belli, Fantini et al 2006, Hu, Gu et al 2009, Zingg, McQuinn et al 2009, Biere, van Berge Henegouwen et al 2012, Swanson, Meyers et al 2012. Numerous commendable user and patient benefits are associated with MIS, yet evidence of a knowledge gap in surgeons' understanding of surgical devices has the potential to negatively impact the clinical outcome of operations (McColl, Karmali et al 2009, Feldman, Fuchshuber et al 2012, Feldman, Brunt et al 2013, Chekan and Whelan 2014. For example, a study survey given to a target test audience demonstrated the consequences of rapid device advancement as it revealed only 28% of respondents considered themselves "experts" in the area of surgical energy-based devices used in MIS (Feldman, Brunt et al 2013).…”