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首页> 外文期刊>Surgical Endoscopy >Prospective cohort study on surgeons' response to equipment failure in the laparoscopic environment
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Prospective cohort study on surgeons' response to equipment failure in the laparoscopic environment

机译：前瞻性队列研究研究外科医生在腹腔镜环境中对设备故障的反应

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Background: Equipment malfunction accounts for approximately one-fourth of surgical errors in the operating room. A serious game was developed to train surgeons in recognizing and responding to equipment failure in minimally invasive surgery (MIS) adequately. This study determined the baseline performance of surgeons, surgical residents, surgical novices, and MIS equipment technicians in solving MIS equipment failure. Methods: The serious game included 37 problem scenarios on the subjects lighting and imaging, insufflation and gas transport, electrosurgery, and pathophysiological disturbances. The scenarios were validated by laparoscopic surgeons and MIS equipment specialists. Forty-nine licensed surgeons, surgical residents, medical students, and MIS equipment specialists played four sessions on the serious game at a surgical convention. Scores on different outcome parameters were compared between groups of a different MIS experience. Results: Laparoscopic equipment specialists solved significantly more MIS equipment-related problems than surgical novices, intermediates, and experts (68.9 vs. 51.0 %, 51.4, and 45.0 %, respectively, p = 0.01). Laparoscopic equipment specialists required significantly fewer steps to solve a problem accurately (median of 1.0 vs. 2.0 for the other groups). Most notably, experienced surgeons were unable to outperform novice and intermediate groups. Experienced surgeons took less time to solve the problems, but made more mistakes in doing so. Conclusions: Experienced surgeons did not outperform inexperienced surgeons in dealing with laparoscopic equipment failure. These results are worrying and need to be addressed by the surgical community.
机译：背景：设备故障约占手术室外科手术错误的四分之一。开发了一个严肃的游戏来培训外科医生，以充分认识和响应微创手术（MIS）中的设备故障。这项研究确定了外科医生，外科住院医师，外科新手和MIS设备技术人员在解决MIS设备故障方面的基准性能。方法：严肃的游戏包括37个问题场景，涉及照明，成像，吹入和输气，电外科手术以及病理生理障碍。该方案已由腹腔镜外科医生和MIS设备专家进行了验证。四十九名持照外科医师，外科住院医师，医学生和MIS设备专家在外科手术大会上进行了四场关于严肃比赛的会议。在具有不同MIS经验的组之间比较了不同结果参数的分数。结果：腹腔镜设备专家解决的MIS设备相关问题比外科新手，中级专家和专家要多得多（分别为68.9％和51.0％，51.4和45.0％，p = 0.01）。腹腔镜设备专家需要更少的步骤来准确地解决问题（其他组的中位数为1.0对2.0）。最值得注意的是，经验丰富的外科医生无法胜过新手和中级人群。有经验的外科医生花费较少的时间来解决问题，但这样做却犯了更多的错误。结论：经验丰富的外科医生在处理腹腔镜设备故障方面并不胜过经验不足的外科医生。这些结果令人担忧，需要手术社区解决。

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