Hamad Giselle G, Brown Matthew T, Clavijo-Alvarez Julio A
Department of Surgery, University of Pittsburgh, 3380 Boulevard of the Allies, Suite 390, Pittsburgh, PA 15213, USA.
Am J Surg. 2007 Jul;194(1):110-4. doi: 10.1016/j.amjsurg.2006.10.027.
Because of the learning curve required to master laparoscopic procedures, there is a growing concern that patient safety may be compromised due to technical errors by a novice surgeon. We evaluated the effect of videotape debriefing on the performance of a complex laparoscopic procedure.
Twenty-four surgical residents performed a laparoscopic jejunojejunal anastomosis under the supervision of a single laparoscopic surgeon. All procedures were videotaped. Half of the residents underwent video debriefing. Videotapes were analyzed for knot-tying time, anastomotic time, and frequency of minor technical errors and adverse events. The performance of the debriefed group was compared with a non-debriefed group.
Knot-tying time, minor errors, and anastomotic time were similar between the debriefed and non-debriefed groups. However, adverse events from technical errors were more frequent in the non-debriefed group (chi2 = 7.647, P = .006).
Postoperative video debriefing is an effective educational tool for reducing adverse events during a complex laparoscopic procedure.
由于掌握腹腔镜手术需要学习曲线，人们越来越担心新手外科医生的技术失误可能会危及患者安全。我们评估了录像汇报对复杂腹腔镜手术操作的影响。
24名外科住院医师在一名腹腔镜外科医生的监督下进行腹腔镜空肠空肠吻合术。所有手术均进行录像。一半的住院医师接受了录像汇报。对录像带进行分析，记录打结时间、吻合时间、轻微技术失误和不良事件的发生频率。将接受汇报的组与未接受汇报的组的表现进行比较。
接受汇报的组与未接受汇报的组在打结时间、轻微失误和吻合时间方面相似。然而，未接受汇报的组中因技术失误导致的不良事件更为频繁（卡方=7.647，P = 0.006）。
术后录像汇报是减少复杂腹腔镜手术中不良事件的有效教育工具。
