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A systematic examination of preoperative surgery warm-up routines

Research output: Contribution to journalArticle

  • T W Pike
  • Samir Pathak
  • Faisal Mushtaq
  • R M Wilkie
  • M Mon-Williams
  • J P A Lodge
Original languageEnglish
Pages (from-to)2202-2214
Number of pages13
JournalSurgical Endoscopy
Volume31
Issue number5
Early online date16 Sep 2016
DOIs
DateAccepted/In press - 23 Aug 2016
DateE-pub ahead of print - 16 Sep 2016
DatePublished (current) - May 2017

Abstract

Background

Recent evidence indicates that a preoperative warm-up is a potentially useful tool in facilitating performance. But what factors drive such improvements and how should a warm-up be implemented?

Methods

In order to address these issues, we adopted a two-pronged approach: (1) we conducted a systematic review of the literature to identify existing studies utilising preoperative simulation techniques; (2) we performed task analysis to identify the constituent parts of effective warm-ups. We identified five randomised control trials, four randomised cross-over trials and four case series. The majority of these studies reviewed surgical performance following preoperative simulation relative to performance without simulation.

Results

Four studies reported outcome measures in real patients and the remainder reported simulated outcome measures. All but one of the studies found that preoperative simulation improves operative outcomes—but this improvement was not found across all measured parameters. While the reviewed studies had a number of methodological issues, the global data indicate that preoperative simulation has substantial potential to improve surgical performance. Analysis of the task characteristics of successful interventions indicated that the majority of these studies employed warm-ups that focused on the visual motor elements of surgery. However, there was no theoretical or empirical basis to inform the design of the intervention in any of these studies.

Conclusions

There is an urgent need for a more rigorous approach to the development of “warm-up” routines if the potential value of preoperative simulation is to be understood and realised. We propose that such interventions need to be grounded in theory and empirical evidence on human motor performance.

    Research areas

  • Warm-up, Surgery, Preoperative simulation, Performance

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  • Full-text PDF (accepted author manuscript)

    Rights statement: This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Springer at https://link.springer.com/article/10.1007/s00464-016-5218-x . Please refer to any applicable terms of use of the publisher.

    Accepted author manuscript, 205 KB, PDF document

    Licence: Unspecified

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