Does speed equal quality? Time pressure impairs minimally invasive surgical skills in a prospective crossover trial

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragen

Abstract

Background: Time pressure can cause stress, subsequently influencing surgeons during minimally invasive procedures. This trial aimed to investigate the effect of time pressure on surgical quality, as assessed by force application and errors during minimally invasive surgical tasks. Methods: Sixty-three participants (43 surgical novices trained to proficiency and 20 surgeons) performed four laparoscopic tasks (PEG transfer, precise Cutting, balloon resection, surgical knot) both with and without time pressure. The primary endpoint was the mean and maximal force exertion during each task. Secondary endpoints were the occurrence of predefined errors and the self-assessed stress level. Results: Time pressure led to a significant shortening of the task time in all four tasks. However, significantly more errors were noticed under time pressure in one task (suture precision P < 0.001). Moreover, time pressure led to a significant increase in mean force in all tasks (PEG: P < 0.001; precision cutting: P = 0.001; surgical knot: P < 0.001; balloon: P = 0.004). In three tasks the maximal force application (PEG: P < 0.001; precision cutting: P < 0.001; surgical knot: P = 0.006) increased significantly. Performing the tasks under time pressure significantly increased the stress level. Cohort analysis revealed that time pressure impaired the performance of both, surgical novices and surgeons but novices were more strongly affected compared to surgeons. Conclusion: Time pressure during minimally invasive surgery may improve procedural time but impair the quality of surgical performance in terms of the incidence of errors and force exertion. Experience may only partially compensate for the negative influence of time pressure.

Details

OriginalspracheEnglisch
Aufsatznummer106813
FachzeitschriftInternational Journal of Surgery
Jahrgang104
PublikationsstatusVeröffentlicht - 8 Aug. 2022
Peer-Review-StatusNein

Externe IDs

Scopus 85135720785
unpaywall 10.1016/j.ijsu.2022.106813
Mendeley 1a0166a3-3638-3b50-bc5e-6fb29556af32
WOS 000860181000010

Schlagworte

ASJC Scopus Sachgebiete

Schlagwörter

  • Force, Stress, Surgical errors, Surgical performance, Time pressure, FORCE, STRESS