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https://hdl.handle.net/2440/102016
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Type: | Journal article |
Title: | Effect of fatigue on laparoscopic skills: a comparative historical cohort study |
Author: | Daruwalla, J. Marlow, N. Field, J. Altree, M. Babidge, W. Hewett, P. Maddern, G. |
Citation: | ANZ Journal of Surgery, 2014; 84(3):137-142 |
Publisher: | Wiley |
Issue Date: | 2014 |
ISSN: | 1445-1433 1445-2197 |
Statement of Responsibility: | J. Daruwalla, N. Marlow, J. Field, M. Altree, W. Babidge, P. Hewett and G.J. Maddern |
Abstract: | Background: Fatigue has been shown to have a negative impact on surgical performance. However, there is a lack of research investigating its effect on laparoscopy, particularly in Australia. This study investigated whether fatigue associated with a surgeon’s usual workday led to a measurable drop off in laparoscopic surgical skills as assessed on a laparoscopic simulator. Methods: A comparative study involving two cohorts was undertaken: a study group whose data were collected prospectively was compared to a historical control group. Participants were required to reach a predetermined level of proficiency in each laparoscopic task on either a FLS or LapSim simulator. The participants in the study cohort were re-tested approximately 1 month after completing 10 h of work. The participants in the historical non-fatigued group were re-tested approximately 1 month after reaching proficiency. Comparisons between cohorts were made using a ‘decrease in score per day elapsed’ value to account for the natural attrition in skills over time and the variability in testing times within and between the two cohorts. Results: The decrease in overall score per day elapsed for fatigued participants was significantly greater than for historical non-fatigued participants, irrespective of the simulator type. Fatigue had a greater impact on certain laparoscopic skills, including peg transfer and knot tying. Participants who self-reported higher level of fatigue demonstrated significantly better skills than those who self-reported lower levels. Conclusion: Overall laparoscopic skill proficiency was reduced in the fatigued participants compared to the historical non-fatigued participants, with certain laparoscopic skills more affected than others. |
Keywords: | coping behaviour; fatigue; laparoscopy; surgeon |
Rights: | © 2013 The Authors ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons |
DOI: | 10.1111/ans.12069 |
Published version: | http://dx.doi.org/10.1111/ans.12069 |
Appears in Collections: | Aurora harvest 7 Medicine publications |
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