TECHNICAL PERFORMANCE
The effect of intraoperative distractions on severe technical events
Published on
August 1, 2021
Surgical Endoscopy
Overview
This study investigated the relationship between intraoperative distractions and technical events during Roux-en-Y gastric bypass surgeries. Researchers analyzed data from 60 cases across three hospitals in Toronto, using the OR Black Box® to record audiovisual and clinical data. They found that distractions occurred frequently, with an average of 47.6 incidents per hour, predominantly machine alarms.
The results revealed a significant association between machine alarms and severe technical events, particularly during high-criticality procedural steps. After adjusting for team factors, the odds of severe technical events increased by 58% with higher rates of machine alarms. This study highlights the potential impact of intraoperative distractions on surgical performance and emphasizes the need for further research to assess mitigation strategies for creating a safer operating room environment.
Results
60 Roux-en-Y cases were analyzed. Average case duration was 83.2 min (SD = 21.97). Distractions occurred 47.6 times/h (SD = 20.3), with most frequent distraction being machine alarms (4.45/10 min, SD = 2.88). For unadjusted analysis, alarms (OR = 1.29, 95% CI 1.05-1.66) and surgeon's technical skills (OR = 0.65, 95% CI 0.43-0.93) were found to be correlated with severe technical events. After adjusting for team factors, alarms were found to be positively related with the presence of severe technical events (OR = 1.58, 95% CI 1.18-2.33) during high-criticality procedural steps.
