Novel minimally invasive transoral surgery bleeding model implemented in a nationwide otolaryngology emergencies bootcamp.


Journal

Journal of robotic surgery
ISSN: 1863-2491
Titre abrégé: J Robot Surg
Pays: England
ID NLM: 101300401

Informations de publication

Date de publication:
Dec 2019
Historique:
received: 02 12 2018
accepted: 02 01 2019
pubmed: 24 1 2019
medline: 25 4 2020
entrez: 24 1 2019
Statut: ppublish

Résumé

Post-operative hemorrhage is the most concerning complication after minimally invasive transoral surgery, as can result in airway compromise. Simulation-based medical education provides trainees with structured learning in an intensive and immersive environment allowing deliberate practice of skills and behaviors in the management of real-life situations. We implemented a novel post-oropharyngeal surgery bleeding model in a nationwide otolaryngology emergencies bootcamp, to teach and evaluate technical and non-technical skills required to competently manage this clinical scenario. 28 Otolaryngology residents from 11 programs in Canada participated in the annual Otolaryngology Emergencies Bootcamp of Western University in London, Ontario. After teaching technical aspects of emergency surgical airways in models, the course culminated with a complex scenario of a post-minimally invasive transoral surgery bleeding model using a fresh cadaver. The Non-Technical Skills for Surgeons (NOTSS) rating scale was applied to video analysis and a scenario-specific Medical Expert Checklist was implemented. The model design in a cadaveric torso is described for use in a simulation of a high-volume oropharyngeal bleed after a minimally invasive approach. Participants agreed that the model evoked an elevated degree of realism and conveyed the emotion of a life-threatening event. NOTSS analysis identified a marginal score in the domains of decision-making and communication and teamwork. Critical action checklist analysis highlighted the early mobilization of available resources and time to decision for surgical airway. We present the first report of a post-minimally invasive transoral surgery bleeding model. It was successful in recreating with high fidelity such a high-stake event and to teach technical and non-technical skills.

Identifiants

pubmed: 30673979
doi: 10.1007/s11701-019-00920-7
pii: 10.1007/s11701-019-00920-7
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

773-778

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Auteurs

Axel Sahovaler (A)

Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
General Surgery Department, Head and Neck Surgery Unit, Italian Hospital of Buenos Aires, Buenos Aires, Argentina.

David E Eibling (DE)

Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Ida Bruni (I)

Department of Anesthesia and Perioperative Medicine London Health Sciences Centre, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

Uma Duvvuri (U)

Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

S Danielle MacNeil (SD)

Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

Anthony C Nichols (AC)

Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

John Yoo (J)

Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

Kevin Fung (K)

Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

Kathryn Roth (K)

Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. kathryn.roth@sjhc.london.on.ca.

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