The effect of stress-inducing conditions on the performance of a laparoscopic task
The effect of stress-inducing conditions on the performance of a laparoscopic task
复制标题
DOI：
10.1007/s00464-002-9224-9
复制
发表时间：
2003-09-01
影响因子：
3.1
通讯作者：
Darzi, A
中科院分区：
文献类型：
--
作者：
Moorthy, K;Munz, Y;Darzi, A
背景：客观的手术技术评估手段的可用性使得评估不利环境条件对手术效果的影响成为可能。方法：参与者在五种条件下进行腹腔镜转移任务：简单的口头数学任务(M)，手术室背景噪音为80至85分贝(N)，尽可能快的表演(T)，所有三种压力源组合(a)和安静条件(Q)。使用运动分析系统和误差评分来评估这些条件对性能的影响。结果：该研究包括13名具有不同水平腹腔镜经验的右撇子外科医生。在T条件下，右手每次运动的路径长度显著增加（p = 0.001）；在M条件下，左手每次运动的路径长度显著增加（p = 0.002）， T条件下（p = 0.01）， a条件下（p = 0.02）。在所有四种应激诱导条件下发生的错误数量明显更高。当所有压力源同时施加时，效果更为明显（p = 0.001），其次是M (p = 0.005)，然后是T （p = 0.01）和N （p = 0.03）。结论：所有三种应激源均导致灵巧性受损和错误发生率增加。
Background: The availability of objective means for assessment of surgical skills has made it possible to evaluate the effect of adverse environmental conditions on surgical performance.Methods: Participants performed a laparoscopic transfer task under five conditions: a simple verbal mathematical task (M), operating theatre background noise at 80 to 85 dB (N), performance as quickly as possible (T), all three stressors combined (A), and quiet conditions (Q). The effect of these conditions on performance was evaluated by using a motion analysis system and an error score.Results: The study included 13 right-handed surgeons with varying levels of laparoscopic experience. There was a significant increase in the path length per movement of the right hand (p = 0.001) under T and a significant increase in the path length per movement of the left hand under M (p = 0.002), T (p = 0.01), and A (p = 0.02). A significantly higher number of errors occurred under all four stress-inducing conditions. The effect was more pronounced when all the stressors were applied in combination (p = 0.001) followed by performance under M (p = 0.005), then T (p = 0.01) and N (p = 0.03).Conclusions: All three stressors led to impaired dexterity and an increase in the incidence of errors.