Critical view of safety in laparoscopic cholecystectomy: A prospective investigation from both cognitive and executive aspects
BackgroundThe achievement rate of the critical view of safety during laparoscopic cholecystectomy is much lower than expected. This original study aims to investigate and analyze factors associated with a low critical view of safety achievement.Materials and MethodsWe prospectively collected laparos...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.946917/full |
| _version_ | 1818472471211278336 |
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| author | Yi Jin Runwen Liu Yonghua Chen Jie Liu Ying Zhao Ailin Wei Yichuan Li Hai Li Jun Xu Xin Wang Ang Li |
| author_facet | Yi Jin Runwen Liu Yonghua Chen Jie Liu Ying Zhao Ailin Wei Yichuan Li Hai Li Jun Xu Xin Wang Ang Li |
| author_sort | Yi Jin |
| collection | DOAJ |
| description | BackgroundThe achievement rate of the critical view of safety during laparoscopic cholecystectomy is much lower than expected. This original study aims to investigate and analyze factors associated with a low critical view of safety achievement.Materials and MethodsWe prospectively collected laparoscopic cholecystectomy videos performed from September 2, 2021, to September 19, 2021, in Sichuan Province, China. The artificial intelligence system, SurgSmart, analyzed videos under the necessary corrections undergone by expert surgeons. Also, we distributed questionnaires to surgeons and analyzed them along with surgical videos simultaneously.ResultsWe collected 169 laparoscopic cholecystectomy surgical videos undergone by 124 surgeons, among which 105 participants gave valid answers to the questionnaire. Excluding those who conducted the bail-out process directly, the overall critical view of safety achievement rates for non-inflammatory and inflammatory groups were 18.18% (18/99) and 9.84% (6/61), respectively. Although 80.95% (85/105) of the surgeons understood the basic concept of the critical view of safety, only 4.76% (5/105) of the respondents commanded all three criteria in an error-free way. Multivariate logistic regression results showed that an unconventional surgical workflow (OR:12.372, P < 0.001), a misunderstanding of the 2nd (OR: 8.917, P < 0.05) and 3rd (OR:8.206, P < 0.05) criterion of the critical view of safety, and the don't mistake “fundus-first technique” as one criterion of the critical view of safety (OR:0.123, P < 0.01) were associated with lower and higher achievements of the critical view of safety, respectively.ConclusionsThe execution and cognition of the critical view of safety are deficient, especially the latter one. Thus, increasing the critical view of safety surgical awareness may effectively improve its achievement rate. |
| first_indexed | 2024-04-14T04:09:10Z |
| format | Article |
| id | doaj.art-16916a9933554373b38be4c931f305b5 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-14T04:09:10Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-16916a9933554373b38be4c931f305b52022-12-22T02:13:17ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-08-01910.3389/fsurg.2022.946917946917Critical view of safety in laparoscopic cholecystectomy: A prospective investigation from both cognitive and executive aspectsYi Jin0Runwen Liu1Yonghua Chen2Jie Liu3Ying Zhao4Ailin Wei5Yichuan Li6Hai Li7Jun Xu8Xin Wang9Ang Li10Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Algorithm, ChengduWithai Innovations Technology Company, Chengdu, ChinaDepartment of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Algorithm, ChengduWithai Innovations Technology Company, Chengdu, ChinaNational Chengdu Center for Safety Evaluation of Drugs, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Science and Technology, Guang'an People's Hospital, Guang'an, ChinaDepartment of Hepatobiliary Surgery, Guang'an People's Hospital, Guang'an, ChinaDepartment of Hepatobiliary Surgery, Chongzhou People's Hospital, Chengdu, ChinaDepartment of Minimal Invasive Surgery, Shangjin Nanfu Hospital, Chengdu, ChinaDepartment of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, ChinaBackgroundThe achievement rate of the critical view of safety during laparoscopic cholecystectomy is much lower than expected. This original study aims to investigate and analyze factors associated with a low critical view of safety achievement.Materials and MethodsWe prospectively collected laparoscopic cholecystectomy videos performed from September 2, 2021, to September 19, 2021, in Sichuan Province, China. The artificial intelligence system, SurgSmart, analyzed videos under the necessary corrections undergone by expert surgeons. Also, we distributed questionnaires to surgeons and analyzed them along with surgical videos simultaneously.ResultsWe collected 169 laparoscopic cholecystectomy surgical videos undergone by 124 surgeons, among which 105 participants gave valid answers to the questionnaire. Excluding those who conducted the bail-out process directly, the overall critical view of safety achievement rates for non-inflammatory and inflammatory groups were 18.18% (18/99) and 9.84% (6/61), respectively. Although 80.95% (85/105) of the surgeons understood the basic concept of the critical view of safety, only 4.76% (5/105) of the respondents commanded all three criteria in an error-free way. Multivariate logistic regression results showed that an unconventional surgical workflow (OR:12.372, P < 0.001), a misunderstanding of the 2nd (OR: 8.917, P < 0.05) and 3rd (OR:8.206, P < 0.05) criterion of the critical view of safety, and the don't mistake “fundus-first technique” as one criterion of the critical view of safety (OR:0.123, P < 0.01) were associated with lower and higher achievements of the critical view of safety, respectively.ConclusionsThe execution and cognition of the critical view of safety are deficient, especially the latter one. Thus, increasing the critical view of safety surgical awareness may effectively improve its achievement rate.https://www.frontiersin.org/articles/10.3389/fsurg.2022.946917/fulllaparoscopic cholecystectomy (LC)critical view of safety (CVS)cognitionexecutionsurgical safety |
| spellingShingle | Yi Jin Runwen Liu Yonghua Chen Jie Liu Ying Zhao Ailin Wei Yichuan Li Hai Li Jun Xu Xin Wang Ang Li Critical view of safety in laparoscopic cholecystectomy: A prospective investigation from both cognitive and executive aspects Frontiers in Surgery laparoscopic cholecystectomy (LC) critical view of safety (CVS) cognition execution surgical safety |
| title | Critical view of safety in laparoscopic cholecystectomy: A prospective investigation from both cognitive and executive aspects |
| title_full | Critical view of safety in laparoscopic cholecystectomy: A prospective investigation from both cognitive and executive aspects |
| title_fullStr | Critical view of safety in laparoscopic cholecystectomy: A prospective investigation from both cognitive and executive aspects |
| title_full_unstemmed | Critical view of safety in laparoscopic cholecystectomy: A prospective investigation from both cognitive and executive aspects |
| title_short | Critical view of safety in laparoscopic cholecystectomy: A prospective investigation from both cognitive and executive aspects |
| title_sort | critical view of safety in laparoscopic cholecystectomy a prospective investigation from both cognitive and executive aspects |
| topic | laparoscopic cholecystectomy (LC) critical view of safety (CVS) cognition execution surgical safety |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.946917/full |
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