ArticleSurgical endoscopy2021
The effect of intraoperative distractions on severe technical events in laparoscopic bariatric surgery.
Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed, 11 citations in OpenAlex.
- Evaluating surgeons' stress using heart rate variability during minimally invasive surgery for gastric cancer: a single-center prospective cohort study.Langenbeck's archives of surgery · 2026Article
- The contribution of surgical data science to identifying intraoperative human errors and adverse events in elective liver surgery: A preliminary study.Annals of hepato-biliary-pancreatic surgery · 2025Article
- Neural insights on expert surgeons' mental workload during live robotic surgeries.Scientific reports · 2025Article
- Defining digital surgery: a SAGES white paper.Surgical endoscopy · 2024Article
- Evolution of the digital operating room: the place of video technology in surgery.Langenbeck's archives of surgery · 2023Review
- The Utility of Video Recording in Assessing Bariatric Surgery Complications.Journal of clinical medicine · 2022Article
- Open surgery tool classification and hand utilization using a multi-camera system.International journal of computer assisted radiology and surgery · 2022Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundGiven the complexity of the operating room (OR), it is unsurprising that surgeons frequently feel distracted while performing operative tasks. However, this relationship is not well studied in live surgeries. The objective of this study is to investigate the relationship between intraoperative distractions and technical events using surgical data.
methodsRoux-en-Y gastric bypass operation data from three tertiary care hospitals in Toronto, Canada were collected prospectively between 2017 and 2019 by a comprehensive operative capture platform (OR Black Box) and analyzed retrospectively. Time-synchronized audiovisual recordings of the OR and laparoscopic videos of the operation were collected, along with clinical data from the electronic health record. Video data was labeled for technical data, non-technical data, and distractions by trained coders. Procedural steps were categorized based on criticality. The relationship between severe technical events (case having 0 or 1 events vs. 2 or more) and the rate of distractions (machine alarms, external communications, people entering/exiting) in critical procedural steps was assessed through logistic regression, adjusting for team factors (surgeons' technical skills, nurse changeovers).
results60 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.
conclusionsThis study showed a significant association between intraoperative distractions, in particular machine alarms, and severe technical events during high-criticality procedural steps. Further investigation will assess the temporal relationship between distractions and technical events and assess mitigation strategies to create a safer surgical environment.
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