Surgical teaching in urology: patient safety and educational value of ‘LIVE’ and ‘SEMI-LIVE’ surgical demonstrations

Legemate, Jaap D.; Zanetti, S.P.; Freund, Jan Erik; Baard, Joyce; Rosette, Jean J.M.C.H. de la

doi:10.1007/s00345-018-2291-x

Cited by 9 publications

(3 citation statements)

References 16 publications

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“…‘As live surgical broadcasts’ are first filmed and then later commented on by the surgeon. When comparing live surgical broadcasts to ‘as live surgical broadcasts’, participants at the World Urology Conference in 2015 and 2019 regarded ‘as live surgical broadcasts’ as slightly better or at least non-inferior to live surgical broadcasts in terms of educational impact 9 10. These authors postulate that ‘as live surgical broadcasts’ provide the same educational advantages, but since the surgeon cannot be distracted by questions, they provide greater surgical safety and a calm working environment for the surgical team.…”

Section: Discussionmentioning

confidence: 99%

Ten years of live surgical broadcast at Charité-MAYO conferences (2010–2019): a systematic evaluation of the surgical outcome

Altmann

Chekerov

Fotopoulou

et al. 2022

Int J Gynecol Cancer

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ObjectiveThe international Charité-MAYO Conference aims to promote international dialog on diagnostics, management, scientific breakthroughs, and state-of-the-art surgical procedures in gynecology and gynecologic oncology and senology. Live surgeries are a fundamental tool of interdisciplinary and international exchange of experts in their respective fields. Currently, there is a controversial and emotional debate about the true value, risks, and safety of live surgical broadcasts. The aim of the current study is to analyze peri-operative risks in patients who were operated live during the Charité-MAYO Conferences.MethodsLive surgeries were performed by the core Charité team consisting of gynecologic oncologic surgeons, breast and plastic surgeons, partly in collaboration with visiting gynecologic oncologic surgeons. We performed a retrospective analysis of live surgeries performed during seven Charité-MAYO Conferences from 2010 to 2019 held in Berlin, Germany. Patients’ files and tumor databases were analyzed as required and patients were contacted to update their long-term follow-up.ResultsSixty-nine patients who were operated live were included. The types of surgery were as follows: urogynecologic procedures (n=13), breast surgery (n=21), and gynecologic oncology surgery for ovarian, uterine, vulvar or cervical cancer (n=35). Peri-operative complications were assessed according to the Clavien–Dindo classification. Despite a high rate of complete resection and the high frequency of multivisceral procedures, the rate of peri-operative complications was within the range published in the literature. Time of surgery and length of intensive unit care and hospital stay did not differ from data acquired at the home institution.ConclusionsBased on our analysis, live surgeries appear to be safe when performed within a multidisciplinary setting without an increase in surgical morbidity and mortality compared with historical controls and without compromise of patients’ outcome. This is the first analysis of its kind to set the basis for patient information and consent for this type of surgeries.

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Section: Discussionmentioning

confidence: 99%

Ten years of live surgical broadcast at Charité-MAYO conferences (2010–2019): a systematic evaluation of the surgical outcome

Altmann

Chekerov

Fotopoulou

et al. 2022

Int J Gynecol Cancer

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“…Participants felt overall the education value was similar and a substantial percentage of the surgeons performing the LBSP reported that they felt that live surgery did not provide optimal circumstances for patient safety. Therefore, the authors advocated the use of more pre-recorded unedited videos [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Safety and effectiveness of live broadcast of surgical procedures: systematic review

et al. 2022

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Introduction Live Broadcast of Surgical Procedures (LBSP) has gained popularity in conferences and educational meetings in the past few decades. This is due to rapid advancement in both Minimally Invasive Surgery (MIS) that enable transmission of the entire operative field and transmission ease and technology to help broadcast the operation to a live audience. The aim of this study was to update the evidence with specific emphasis on the patient safety issues related to LBSP in MIS. Methods A systematic review of the literature was performed using Medline, Embase and Pubmed using defined search terms related to LBSP in educational events across all surgical specialities, in accordance with the PRISMA guidelines. We also consolidated the prior guidelines and position statements on this topic. Outcomes included reports on the educational value of LBSP as well as patient safety outcomes and ethical issues that were captured by clinical outcomes. Results A total 1230 abstracts were identified with 27 papers meeting the inclusion criteria (13 original articles and 14 position statements/guidelines). All studies highlighted the educational benefits of LBSP but without clear measure of these benefits. Clinical outcomes were not compromised in 9 studies but were inferior in the remaining 4, including lower completion rate of endoscopic surgery and higher rate of re-operation. Only nine studies complied with dedicated consent forms for LBSP with no consistent approach of reporting on maintaining patient confidentiality during LBSP. There was a lack of recommendation on standardised approach of reporting on LBSP including the outcomes across the 14 published guidelines and positions statements. Conclusions Live Broadcast of Surgical Procedures can be of educational value but patient safety may be compromised. A standardised framework of reporting on LBSP and its outcomes is required from an ethical and patient safety perspective. PROSPERO registration CRD42021256901. Supplementary Information The online version contains supplementary material available at 10.1007/s00464-022-09072-6.

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“…A recently performed survey by Legemate et al conducted at the 2017 Challenges in Endourology congress reiterated that attendees attribute LSEs and SLSDs the same learning experience, while a substantial percentage of surgeons who had performed LSDs stated patient safety may be jeopardized. Nevertheless, one-third of the responders would attend fewer SEMs if SLSDs were to replace LSDs [21]. This finding suggests that despite all technological progress and benefits of SLSDs, LSDs remain a popular tool for surgical education.…”

Section: Discussionmentioning

confidence: 99%

Learning benefits of live surgery and semi-live surgery in urology—informing the debate with results from the International Meeting of Reconstructive Urology (IMORU) VIII

et al. 2020

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Purpose To analyze the perceived learning opportunities of participants of the International Meeting on Reconstructive Urology (IMORU) VIII for both live surgery demonstrations (LSD) and semi-live surgery demonstrations (SLSD). Safety and educational efficacy of LSD and SLSD at live surgery events (LSE) have been debated extensively, however, objective data comparing learning benefits are missing. Methods We conducted a detailed survey, which employed the Kirkpatrick model, a well-established assessment method of training models, to investigate participants preferences as well as the learning benefit of LSE. Furthermore, we employed an audience response system and the Objective Structured Assessment of Technical Skills (OSATS), a well-established assessment method of surgery skills, to let our participants rate the perceived learning opportunity of LSD and SLSD. Results Of 229 participants at the IMORU VIII, 39.7% returned our questionnaires. 90% stated that they prefer LSD. On all levels of Kirkpatrick’s training evaluation model, the IMORU received high ratings, suggesting a high learning benefit. For the assessment of OSATS, a total of 23 surgical cases were evaluable. For all six utilized items, LSD scored significantly better ratings than SLSD. Conclusion Our study suggests that there is still a rationale for LSD, as participants attributed a statistically significant higher learning benefit to LSD over SLDS. Evaluation of the survey showed that for LSE such as the IMORU VIII, a high learning benefit can be expected. Considering that most of our participants are active surgeons with high caseloads, their opinion on the educational value of LSE is of high relevance.

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Surgical teaching in urology: patient safety and educational value of ‘LIVE’ and ‘SEMI-LIVE’ surgical demonstrations

Cited by 9 publications

References 16 publications

Ten years of live surgical broadcast at Charité-MAYO conferences (2010–2019): a systematic evaluation of the surgical outcome

Ten years of live surgical broadcast at Charité-MAYO conferences (2010–2019): a systematic evaluation of the surgical outcome

Safety and effectiveness of live broadcast of surgical procedures: systematic review

Learning benefits of live surgery and semi-live surgery in urology—informing the debate with results from the International Meeting of Reconstructive Urology (IMORU) VIII

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