TPT 7.09 Surgical experience and identification of errors in laparoscopic cholecystectomy
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ID: 323921
2026
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Abstract
Abstract Background Surgical errors are acts/omissions resulting in negative consequences and/or increased operative time. Surgeon-reported errors in laparoscopic cholecystectomy are described. Methods Intraoperative videos were uploaded/annotated on TouchSurgeryTM Enterprise. Participants evaluated videos using a 10-point intraoperative cholecystitis grading score and errors using Observational Clinical Human Reliability Assessment, which includes skill, consequence, and mechanism classifications. Results Nine videos were assessed by 8 participants (3 junior (Specialist Trainees (ST)3-5), 2 senior trainees (ST6-8), 3 consultants). Participants identified 550 errors. Positive relationships were seen between total operative time and error count (EC) (r2=0.284, p<0.001), and intraoperative grade score and EC (r2=0.578, p=0.001), and total operative time (r2=0.157, p<0.001). Significantly different ECs across intraoperative phases (H(6)=47.06,(p<0.001)) were found, most frequently, at dissection of Hepatocystic Triangle (DHCT) (n=282,median=33.5,IQR=24.3, range=15-63), ligation/division of cystic structures (LDCS) (n=124,IQR=7.3, range=10-16) and gallbladder dissection (GBD). (n=117, median=14.5, IQR=8.5, range=6-20). No significantly different ECs between juniors, seniors, and consultants (H(2)=0.027, p=0.987)) were found. Errors were classified differently. DHCT: thermal injuries (n=50) were frequently classified executional, consequential errors. Trainees classified thermal injuries as “excessive force/speed/depth/distance/time/rotation” (58%) whereas consultants classified as “incorrect orientation” (12%). LDCS: inappropriate clipping (n=60) procedural errors were reported by junior trainees (22%), but not consultants. GBD: consultants and seniors reported inappropriate dissection (n=20) in incorrect planes (35%), juniors did not. Poor economy of movement (n=11) was reported more by consultants (73%) than trainees (27%). Conclusion This study suggests surgical experience influences error interpretation. Further research is needed into the benefits for surgical training.
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| Authors | Gemma Humm, Adam Peckham-Cooper, Jessica Chang, Roland Fernandes, Naim Fakih Gomez, Helen Mohan, Deirdre Nally, Anthony Thaventhiran, Roxanna Zakeri, Anaya Gupte, James Crosbie, Christopher Wood, Khaled Dawas, Danail Stoyanov, Laurence Lovat |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag087.249
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| URL | |
| Keywords | Keywords not found |
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