What Not To Do While Your Surgeons Operate

Don't move around the OR unexpectedly, turn off your cell phone, stop carrying on conversations unrelated to surgery and try not to drop metal trays on the floor. And definitely don't do any of those disruptive activities during afternoon cases.

A new study in Archives of Surgery says general surgery residents made major surgical errors during 8 of 18 simulated procedures purposely interrupted with these real-life distractions, while only 1 error was made during 18 operations performed without intrusions.

The residents had enough cognitive resources to perform the simulated surgical procedures when not distracted or interrupted, but not enough cognitive resources to perform surgery while their focus was directed away from the surgical site, note the study's authors.

The study also suggests a link between the time of day a surgery is performed and the likelihood for a surgical error. The researchers found that all 8 errors occurred during procedures starting after 1 p.m., noting that neither fatigue nor the order in which they performed the simulations — interrupted or uninterrupted — factored in the mistakes. "It is as if the OR distractions and interruptions put them over the edge (in the afternoon)," they say.

While fatigue was not an error-causing factor, the researchers speculate that diurnal variations in blood concentrations of nutrients and hormones, whether the surgeon had eaten lunch (and if so, when), and consumption of coffee or energy drinks may have impacted the surgeons' concentration.

Mark McGraw