Application of Failure Mode and Effect Analysis in Laparoscopic Colon Surgery Training

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• 作者：Francisco Alba Mesa (1)
  Miguel Angel Sanchez Hurtado (2)
  Francisco Miguel Sanchez Margallo (2)
  Virginia Gomez Cabeza de Vaca (1)
  Andrzej L. Komorowski (3)
  
  1. Consorcio Sanitario Publico del Aljarafe ; Hospital San Juan de Dios ; Bormujos ; Sevilla ; Spain
  2. Department of Laparoscopic Surgery ; Minimally Invasive Surgery Centre Jes煤s Us贸n ; C谩ceres ; C谩ceres ; Spain
  3. Department of Surgical Oncology ; Maria Sk艂odowska-Curie Memorial Cancer Centre and Institute of Oncology ; ul.Garncarska 11 ; 31-115 ; Krak贸w ; Poland
  
• 刊名：World Journal of Surgery
• 出版年：2015
• 出版时间：February 2015
• 年：2015
• 卷：39
• 期：2
• 页码：536-542
• 全文大小：358 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Abdominal Surgery
  Cardiac Surgery
  General Surgery
  Thoracic Surgery
  Vascular Surgery
  
• 出版者：Springer New York
• ISSN：1432-2323

文摘

Aim To evaluate if application of failure mode and effect analysis (FMEA) to laparoscopy training can help surgeons acquire laparoscopy skills. Methods After preparing a FMEA matrix of laparoscopic sigmoidectomy, we have introduced it during three laparoscopy courses. Forty-eight surgeons, divided into 24 teams of two surgeons, have participated in three courses. During each course, every team has performed three laparoscopic sigmoidectomies in three experimental animals (1 OR session every day). Risk priority number (RPN) has been calculated for every surgery, and the results have been discussed at the end of each training day with all participants. Results We have observed a decline in the median RPN from 1339 during the first OR session through 62 during second OR session to reach 0 in the third OR session. Only two teams out of 24 were not able to reach a RPN of less than 300 during third OR session. When the type of failures were analysed, we have observed a shift from procedure-type failures to technical failures that depended on each participant technical abilities. Conclusion Application of FMEA principles to laparoscopy training can help acquire non-technical skills necessary for safe laparoscopic surgery.