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Effect of fatigue on laparoscopic skills: a comparative historical cohort study.
MedLine Citation:
PMID:  23351016     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
Jurstine Daruwalla; Nicholas Marlow; John Field; Meryl Altree; Wendy Babidge; Peter Hewett; Guy J Maddern
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-27
Journal Detail:
Title:  ANZ journal of surgery     Volume:  -     ISSN:  1445-2197     ISO Abbreviation:  ANZ J Surg     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101086634     Medline TA:  ANZ J Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 The Authors. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.
Affiliation:
Department of Surgery, Alfred Hospital, Melbourne, Victoria, Australia.
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