Analysis of errors in laparoscopic surgical procedures - A new methodology
Analysis of errors in laparoscopic surgical procedures - A new methodology
复制标题
DOI：
10.1007/s00464-002-8927-2
复制
发表时间：
2004-04-01
影响因子：
3.1
通讯作者：
Satava, RM
中科院分区：
文献类型：
--
作者：
Seymour, NE;Gallagher, AG;Satava, RM
背景：确定腹腔镜术者的能力是培训避免差错的关键。本研究描述了一种实用的手术差错分析方法。方法：在回顾了腹腔镜手术切除阶段的实践录像带后，就八个差错的识别达成了共识。在这一阶段结束时，评分员之间的一致性为84-96%。然后，14盘胆囊切除的研究录像带由专家评审员独立观察，他们对手术团队的身份视而不见。结果：对于所有错误类别，评分者之间的一致性为84%-100%。结论：本研究表明，通过仔细定义和训练对目标事件的识别，可以实现评价者之间对程序性错误的良好一致性。将这一简单可靠的分析工具扩展到其他程序应该是可行的，以确定导致不良临床结果的行为。
Background: The determination of laparoscopic surgeon ability is essential to training error avoidance. The present study describes a practical method of surgical error analysis.Methods: After review of practice videotapes of the excisional phase of laparoscopic cholecystectomy, consensus on the identification of eight errors was achieved. Interrater agreement at the end of this phase was 84-96%. Fourteen study videotapes of gallbladder excision were then observed independently by expert reviewers blinded to Surgical team identity. Procedures were assessed using a scoring matrix of 1-min segments with each error reported each minute.Results: Interrater agreement was 84-100% for all error catagories.Conclusions: The present study demonstrates that excellent interrater agreement of procedural errors can be achieved by carefully defining and training recognition of targeted events. Extension of this simple and reliable analysis tool to other procedures should be feasible to define behaviors leading to adverse clinical outcomes.