Page 19 - WJOLS - Surgery Journal

World Journal of Laparoscopic Surgery, January-April 2009;2(1):17-19
Analysis of Errors in Laparoscopic Cholecystectomy
Analysis of Errors in Laparoscopic

Cholecystectomy

Ali Aminian
Assistant Professor of General Surgery, Tehran University of Medical Sciences, Iran

INTRODUCTION DISCUSSION
Laparoscopic cholecystectomy (LC), as a standard of care in Training in error analysis and prevention has been well-established
symptomatic gallstone disease, is the most commonly in high-risk activities such as aviation and space travel. There
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performed operation of the gastrointestinal tract. However, has been little research in why and how errors occur during
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complication rate of LS is higher than open surgery, which surgery. Additionally, most of these studies concentrate on
is not a matter for discussion only at morbidity and mortality postoperative adverse events and do not reflect on surgical
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conferences or at meetings: patients are being injured. In technical skill errors and why they may occur. Several studies
surgical practice even a simple error may have profound have indicated that most of the adverse events are preventable. 7,8
consequences. Performing laparoscopic surgery involves a complex cascade
Surgical practice must be effective and safe. One of the of psychomotor skills. While performing such highly technical
most important responsibilities of surgical educators is tasks, it may be very difficult not to commit some errors.
teaching of safe surgery. Accordingly, one of the main Therefore, the recognition and the execution of errors is an
objectives of world association of laparoscopic surgeons important task for surgeons. 6,8-10
(WALS) is education of correct way of minimal access surgery. A good method for assessing and improving knowledge is
The aim of this study is to increase the awareness of to try to detect errors. Previous studies confirmed that the ability
laparoscopic surgeons about possible errors during laparos- to detect errors is closely correlated with technical performance.
copic procedures. By examining the error rather than reading a book or having a
verbal explanation may help improve their avoidance. 11,12 In
MATERIAL AND METHODS conclusion, this study will try to improve the knowledge and
subsequently the skill of laparoscopic surgeons in a novel fashion.
In the attached DVD to this issue of world journal of
laparoscopic surgery (WJLS), there is a video of LC with several ANALYSIS OF ERRORS IN LAPAROSCOPIC
errors. This operation was performed by a general surgery CHOLECYSTECTOMY
resident postgraduate year 4 in the teaching university hospital One of the main objectives of world association of laparoscopic
without the attending supervision in December 2008. This real- surgeons (WALS) is education of correct way of minimal access
time video was divided into 10 parts. A questionnaire form surgery. It has been proved that a good method for assessing
(both paper-based and computer-based) has been made. It and improving knowledge is to try to detect errors. The aim of
included the demographic data and a table. It is expected that this study is to increase the awareness of laparoscopic surgeons
the surgeons see the video carefully and write all errors about possible errors during laparoscopic procedures. There is
happened in each parts of the operation. The completed form a video of laparoscopic cholecystectomy with several errors.
can be sent to quiz@wals.in. An award and certificate will be This real-time video was divided into 10 parts. A questionnaire
given to five surgeons specifying more errors in each parts of form (including demographic data and tables) in word format
video by WALS during the next upcoming WALS meeting at has been made. We request to see the video and write all errors
2010. happened in each parts of the operation. The completed form
can be sent to quiz@wals.in Deadline for sending the answers
RESULTS will be at the end of the June 2009. An award and certificate will
After receiving and analyzing the answers, a complete set of be given to five surgeons specifying more errors in each parts
errors happened in this video will be published in the next issue of video by WALS during the next upcoming WALS meeting
of WJLS. This process will increase the awareness of at 2010.
laparoscopic surgeons about different errors in LC and has a Please see the video for errors and write in the Table below:
great educational impact. Download the video from http://wals.in/quiz.htm

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