Journal article
Designing safety into the minimally invasive surgical revolution
Surgical endoscopy, v 23(1)
01 Jan 2009
PMID: 18815835
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Surgical errors with minimally invasive surgery differ from those in open surgery. Perforations are typically the result of trocar introduction or electrosurgery. Infections include bioburdens, notably enteric viruses, on complex instruments. Retained foreign objects are primarily unretrieved device fragments and lost gallstones or other specimens. Fires and burns come from illuminated ends of fiber-optic cables and from electrosurgery. Pressure ischemia is more likely with longer endoscopic surgical procedures. Gas emboli can occur.
Minimally invasive surgery is more dependent on complex equipment, with high likelihood of failures. Standardization, checklists, and problem reporting are solutions for minimizing failures. The necessity of electrosurgery makes education about best electrosurgical practices important.
The recording of minimally invasive surgical procedures is an opportunity to debrief in a way that improves the reliability of future procedures. Safety depends on reliability, designing systems to withstand inevitable human errors. Safe systems are characterized by a commitment to safety, formal protocols for communications, teamwork, standardization around best practice, and reporting of problems for improvement of the system.
Teamwork requires shared goals, mental models, and situational awareness in order to facilitate mutual monitoring and backup. An effective team has a flat hierarchy; team members are empowered to speak up if they are concerned about problems. Effective teams plan, rehearse, distribute the workload, and debrief.
Surgeons doing minimally invasive surgery have a unique opportunity to incorporate the principles of safety into the development of their discipline.
Metrics
Details
- Title
- Designing safety into the minimally invasive surgical revolution
- Creators
- John R. Clarke - Drexel University
- Publication Details
- Surgical endoscopy, v 23(1)
- Publisher
- Springer Nature
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- [Retired Faculty]
- Web of Science ID
- WOS:000262089300037
- Scopus ID
- 2-s2.0-58149196388
- Other Identifier
- 991019169545804721
UN Sustainable Development Goals (SDGs)
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Surgery