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Workload Differentiates Breast Surgical Procedures: NSM Associated with Higher Workload Demand than SSM.

ABSTRACT: BACKGROUND:Breast surgery has evolved with more focus on improving cosmetic outcomes, which requires increased operative time and technical complexity. Implications of these technical advances in surgery for the surgeon are unclear, but they may increase intraoperative demands, both mentally and physically. We prospectively evaluated mental and physical demand across breast surgery procedures, and compared surgeon ergonomic risk between nipple-sparing (NSM) and skin-sparing mastectomy (SSM) using subjective and objective measures. METHODS:From May 2017 to July 2017, breast surgeons completed modified NASA-Task Load Index (TLX) workload surveys after cases. From January 2018 to July 2018, surgeons completed workload surveys and wore inertial measurement units to evaluate their postures during NSM and SSM cases. Mean angles of surgical postures, ergonomic risk, survey items, and patient factors were analyzed. RESULTS:Procedural duration was moderately related to surgeon frustration, mental and physical demand, and fatigue (p?

SUBMITTER: Hallbeck MS

PROVIDER: S-EPMC7138769 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Workload Differentiates Breast Surgical Procedures: NSM Associated with Higher Workload Demand than SSM.

Hallbeck M Susan MS Law Katherine E KE Lowndes Bethany R BR Linden Anna R AR Morrow Melissa M Blocker Renaldo C RC Cain Stephen M SM Degnim Amy C AC Hieken Tina J TJ Jakub James W JW Racz Jennifer M JM Farley David R DR Nelson Heidi H Boughey Judy C JC

Annals of surgical oncology 20200108 5

<h4>Background</h4>Breast surgery has evolved with more focus on improving cosmetic outcomes, which requires increased operative time and technical complexity. Implications of these technical advances in surgery for the surgeon are unclear, but they may increase intraoperative demands, both mentally and physically. We prospectively evaluated mental and physical demand across breast surgery procedures, and compared surgeon ergonomic risk between nipple-sparing (NSM) and skin-sparing mastectomy (S ...[more]

PMID: 31916090

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Project description:BackgroundDuring the implementation of new interventions (i.e., surgical devices and technologies) in the operating room, surgical safety might be compromised. Current safety measures are insufficient in detecting safety hazards during this process. The aim of the study was to observe whether surgical teams are capable of measuring surgical safety, especially with regard to the introduction of new interventions.MethodsA Surgical Safety Questionnaire was developed that had to be filled out directly postoperative by three surgical team members. A potential safety concern was defined as at least one answer between (strongly) disagree and indifferent. The validity of the questionnaire was assessed by comparison with the results from video analysis. Two different observers annotated the presence and effect of surgical flow disturbances during 40 laparoscopic hysterectomies performed between November 2010 and April 2012.ResultsThe surgeon reported a potential safety concern in 16% (85/520 questions). With respect to the scrub nurse and anesthesiologist, this was both 9% (46/520). With respect to the preparation, functioning, and ease of use of the devices in 37.5-47.5% (15-19/40 procedures) a potential safety concern was reported by one or more team members. During procedures after which a potential safety concern was reported, surgical flow disturbances lasted a higher percentage of the procedure duration [9.3 ± 6.2 vs. 2.9 ± 3.7% (mean ± SD), p < .001]. After procedures during which a new instrument or device was used, more potential safety concerns were reported (51.2 vs. 23.1%, p < .001).ConclusionsPotential safety concerns were especially reported during procedures in which a relatively high percentage of the duration consisted of surgical flow disturbances and during procedures in which a new instrument or device was used. The Surgical Safety Questionnaire can act as a validated tool to evaluate and maintain surgical safety during minimally invasive procedures, especially during the introduction of a new intervention.

Dataset Information

Workload Differentiates Breast Surgical Procedures: NSM Associated with Higher Workload Demand than SSM.

Publications

Workload Differentiates Breast Surgical Procedures: NSM Associated with Higher Workload Demand than SSM.

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