Oops, I Wish I Hadn’t Done That – Part 3

Our “Innovations” section took a two-month hiatus to make room for publicizing a series of prostate cancer awareness community events. We will continue with our series on avoiding and managing surgical complications with attention to surgical technique. In parts one and two, we covered the importance of the patient care team and the importance of preparation. Of course, surgical technique can be a significant factor, especially in the following situations:

  • Complex anatomy or pathology
  • Surgeon fatigue
  • Over-reliance on technology

As surgeons, we have little control over the anatomy, but here are some steps we can take:

  • Proper patient selection
  • Proper patient positioning
  • Meticulous exposure
  • Adequate audio volume for all cautery equipment activations and device alarms (e.g. insufflation)
  • Mental or written checklists of all procedural steps

Surgeon and surgical team fatigue can be a significant factor during lengthy cases, especially when scheduled following other procedures or at the end of a day. As always, we should be very attentive of ergonomic concerns such as table and monitor heights. Sometimes a two-minute break is all it takes to keep things on track.

Over-reliance on technology can be detrimental at times. I refer to this phenomenon as “inattentive blindness.” As a real-life example, if you always rely on your car’s rearview camera, an eventual collision is inevitable. A device should complement rather than replace human judgment.