TY  - JOUR
U1  - Zeitschriftenartikel, wissenschaftlich - begutachtet (reviewed)
A1  - Rolinger, Jens
A1  - Model, Nils
A1  - Jansen, Kai
A1  - Knöll, Madeleine
A1  - Beyersdorffer, Patrick
A1  - Kunert, Wolfgang
A1  - Axt, Steffen
A1  - Kirschniak, Andreas
A1  - Wilhelm, Peter
T1  - Quantification of electrosurgery-related critical events during laparoscopic cholecystectomy – a prospective experimental study among surgical novices
JF  - 4Open
N2  - Uncontrolled movement of instruments in laparoscopic surgery can lead to inadvertent tissue damage, particularly when the dissecting or electrosurgical instrument is located outside the field of view of the laparoscopic camera. The incidence and relevance of such events are currently unknown. The present work aims to identify and quantify potentially dangerous situations using the example of laparoscopic cholecystectomy (LC). Twenty-four final year medical students were prompted to each perform four consecutive LC attempts on a well-established box trainer in a surgical training environment following a standardized protocol in a porcine model. The following situation was defined as a critical event (CE): the dissecting instrument was inadvertently located outside the laparoscopic camera’s field of view. Simultaneous activation of the electrosurgical unit was defined as a highly critical event (hCE). Primary endpoint was the incidence of CEs. While performing 96 LCs, 2895 CEs were observed. Of these, 1059 (36.6%) were hCEs. The median number of CEs per LC was 20.5 (range: 1–125; IQR: 33) and the median number of hCEs per LC was 8.0 (range: 0–54, IQR: 10). Mean total operation time was 34.7 min (range: 15.6–62.5 min, IQR: 14.3 min). Our study demonstrates the significance of CEs as a potential risk factor for collateral damage during LC. Further studies are needed to investigate the occurrence of CE in clinical practice, not just for laparoscopic cholecystectomy but also for other procedures. Systematic training of future surgeons as well as technical solutions address this safety issue.
KW  - surgical training
KW  - laparoscopic surgery
KW  - inadvertent injury
KW  - electrosurgery
KW  - patient safety
KW  - prospective experimental study
Y1  - 2022
UN  - https://nbn-resolving.org/urn:nbn:de:bsz:rt2-opus4-40857
SN  - 2557-0250
SS  - 2557-0250
U6  - https://doi.org/10.1051/fopen/2022001
DO  - https://doi.org/10.1051/fopen/2022001
VL  - 5
SP  - 1
EP  - 8
S1  - 8
PB  - EDP Sciences
CY  - Les Ulis
ER  -