Abstract:
BACKGROUND AND PURPOSE:Surgical outcomes depend on patient and disease-related factors, as well as the technical skill of the surgeon. Various distractions in the operating room (OR) environment have been shown to negatively impact a surgeon's performance. A survey was conducted with the objective to evaluate and characterize distractions during urologic surgery. METHODS:An Internet-based survey was distributed to 2057 international urologists via email between April and October 2011; questions focused on a variety of disruptive factors postulated to have a negative impact on surgical performance. RESULTS:Of the 523 (25%) respondents, 58% practiced in North America, 42% were from an academic institution, and 68% had completed a clinical fellowship. In an average year, 83% reported having operated at least once while sleep deprived, 84% when significantly ill, 55% with a musculoskeletal injury, and 65% under significant social stress. Up to 38% reported that on at least one occasion, such "internal distractions" had significantly affected surgical performance and 14% perceived that at least one surgical complication was caused mainly by an internal distraction. Less than 50% had ever cancelled surgery because of an internal distraction. Music was routinely played in the OR by 57% of respondents, >67% reported answering pages and discussing consults while operating, and 25% reported "commonly" working with scrub nurses/techs that were unfamiliar with the procedure and/or instruments. Only 44% had consistent individual(s) assisting, and 27% reported that the scrub nurse/tech would "commonly" scrub out during a critical portion of the procedure. Overall, 14.5% reported that at least one complication had occurred mainly because of such "external" or "interactive" distractions. CONCLUSIONS:Urologists face various distractions in the OR that can negatively impact surgical performance, potentially compromising patient outcomes and safety. Further studies are needed to elucidate the true impact of such distractions and to develop strategies to mitigate their effects.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Lee JY,Lantz AG,McDougall EM,Landman J,Gettman M,Sweet R,Sundaram CP,Zorn KCdoi
10.1089/end.2012.0704subject
Has Abstractpub_date
2013-09-01 00:00:00pages
1161-5issue
9eissn
0892-7790issn
1557-900Xjournal_volume
27pub_type
杂志文章abstract:PURPOSE:We evaluated the collagen content and differentiation of the ureteropelvic junction (UPJ) of patients who underwent Anderson-Hynes dismembered pyeloplasty after failure of antegrade endopyelotomy. MATERIALS AND METHODS:A total of 12 UPJ obstructions were examined more than 12 months after endopyelotomy with bo...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.9996
更新日期:2007-01-01 00:00:00
abstract:PURPOSE:To evaluate the feasibility of using the potassium titanyl phosphate (KTP) laser to perform laparoscopic partial nephrectomy in a porcine model, with saline irrigation to reduce intraoperative smoke formation. MATERIALS AND METHODS:A high-power (80 W) KTP laser was used without hilar occlusion in 14 laparoscop...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.20.1096
更新日期:2006-12-01 00:00:00
abstract::In one-third of patients, prostate cancer (PCa) is monofocal. These patients can undergo focal high-intensity focused ultrasound (HIFU) therapy of the tumor without damage to surrounding structures and not compromising uro-oncologic safety. Robot-assisted HIFU coagulates the entire targeted volume within the prostate ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2009.0439
更新日期:2010-05-01 00:00:00
abstract:: Objectives: To compare the efficacy, complications, and costs of percutaneous nephrolithotomy (PNL) and extracorporeal shock wave lithotripsy (SWL) in the treatment of a 20 to 30 mm single renal pelvic stone with a density ≤1000 HU. Patients and Me...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0288
更新日期:2020-11-01 00:00:00
abstract:INTRODUCTION:Patients with ileal conduit urinary diversions are at an increased risk of long-term upper urinary tract (UUT) complications, including anastomotic strictures, infections, and urolithiasis. The reconstructed urinary system poses challenges for endoscopic manipulation. We present and describe our dual-cente...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2017.0271
更新日期:2017-09-01 00:00:00
abstract:: Purpose: Kidney stone recurrence rates vary between patients. A patient's risk informs the frequency and intensity of preventative interventions. Clinicians routinely use clinical experience to estimate risk. We sought to compare clinician estimated recurrence risk with th...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0978
更新日期:2020-11-16 00:00:00
abstract:PURPOSE:Laparoscopic bladder augmentation has been limited because of the extensive suturing required. The use of robot-assisted laparoscopic (RAL) procedures may circumvent this limitation and allow more efficient suturing. The purpose of the study is to define the techniques and the potential pitfalls in performing R...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.0238
更新日期:2008-02-01 00:00:00
abstract::A new technique of endosurgical pelvic lymph node dissection was performed for the staging of 10 prostate and 8 bladder cancers. The technique, involving an exclusive extraperitoneal space development with CO2 insufflation, is described in detail. Using the standard endosurgical (laparoscopic) equipment, we performed ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1993.7.229
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Kidney stone disease is rare in the South African black (B) population and more prevalent in the white (W) population. Genetic studies have not previously examined this anomaly. The AGT Pro11Leu polymorphism in the alanine:glyoxylate aminotransferase (AGT) enzyme has been suggested as possibly pl...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0617
更新日期:2014-05-01 00:00:00
abstract::In this review, a simplified straightforward algorithmic approach to the metabolic evaluation and treatment of the at-risk or recurrent urolithiasis patient is provided. Eight diagnoses and eight therapies are provided, which cover over 95% of renal stone disease. ...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2017.0541
更新日期:2018-05-01 00:00:00
abstract:PURPOSE:To assess the long-term outcome of early endoscopic realignment (EER) of complete posterior urethral disruption. PATIENTS AND METHODS:The study included 11 consecutive patients with complete posterior urethral disruption secondary to a road accident (n = 9) or a falling impact (n = 2). EER was performed using ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2010.0069
更新日期:2010-07-01 00:00:00
abstract:INTRODUCTION:The impact of intrafascial versus interfascial nerve sparing during radical prostatectomy on oncologic and postoperative outcome is still controversial. This manuscript compares the outcomes of intrafascial versus interfascial techniques of nerve sparing used during robot-assisted laparoscopic radical pros...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2009.0369
更新日期:2009-09-01 00:00:00
abstract:INTRODUCTION:Renal papillary pits are commonly encountered during ureteroscopy. The mechanism by which such pits arise is unclear. One hypothesis is that pits represent sites where stones overgrowing Randall's plaque (RP) were dislodged. We sought to examine this theory by using digital ureteroscopy and stone μCT. MAT...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2018.0589
更新日期:2019-04-01 00:00:00
abstract::The long-term effects of extracorporeal shockwave lithotripsy (SWL) on children treated for renal calculi are unclear. To study the effects on the immature animal, we evaluated 31 Wistar white rats that underwent right nephrectomy at 30 days of age. At 40 days of age they were divided into three groups: a control grou...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1995.9.45
更新日期:1995-02-01 00:00:00
abstract:PURPOSE:The goal of this study is to identify the most efficient sweeping angle (SA) during photoselective vaporization of the prostate (PVP). MATERIALS AND METHODS:Experiments were conducted with GreenLight XPS™ laser at 120 and 180 W. Ten blocks of porcine kidney were used for each SA (0, 15, 30, 45, 60, 90, and 120...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2011.0356
更新日期:2012-04-01 00:00:00
abstract:INTRODUCTION:Morcellation of the adenoma after laser enucleation of the prostate (LEP) is both time-consuming and prone to complications. We have designed a novel polyethylene sack (ProSac) to improve the morcellation process following LEP. Both silicone and cadaver models were utilized to evaluate the safety and effic...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2018.0618
更新日期:2018-12-01 00:00:00
abstract:: Introduction: Calcium oxalate (CaOx) is the predominate component within renal calculi and can be divided into two subtypes: CaOx-monohydrate (COM) and CaOx-dihydrate (COD). COM and COD form in differing urinary environments, which suggest differential underlying metabolic...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2019.0245
更新日期:2019-09-01 00:00:00
abstract::Lasertripsy of upper urinary tract calculi after unsuccessful extracorporeal lithotripsy (SWL) or ureteroscopy (Group 1; N = 26 patients, 36 calculi) was compared with primary lasertripsy (Group 2; N = 56 patients, 79 calculi). Access to calculi was achieved by a Candela miniscope or flexible ureteroscope, and laser f...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1993.7.473
更新日期:1993-12-01 00:00:00
abstract:: Background: Nonmuscle-invasive bladder cancer is diagnosed, treated, and monitored using cystoscopy. Artificial intelligence (AI) is increasingly used to augment tumor detection, but its performance is hindered by the limited availability of cystoscopic images required to ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0919
更新日期:2020-12-04 00:00:00
abstract:PURPOSE:To assess the efficacy, safety, and morbidity of tubeless percutaneous nephrolithotomy (PCNL) and compare it with standard PCNL. PATIENTS AND METHODS:A total of 135 patients (140 renal units) undergoing tubeless PCNL (group 1) from June 2000 to September 2007 were compared with a similar group of 185 (194 rena...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.0338
更新日期:2008-07-01 00:00:00
abstract:PURPOSE:To analyze the early outcome after single tract vs multiple tracts percutaneous nephrolithotomy (PCNL) in the management of staghorn calculi. PATIENTS AND METHODS:The records of 413 patients with staghorn calculi (223 [54%] had complete and 190 [46%] had partial) who underwent PCNL were reviewed retrospectivel...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2009.0456
更新日期:2010-06-01 00:00:00
abstract::Because it is still a puzzling debate whether ligation of a unilateral varicose spermatic vein is worth performing by laparoscopy, even with the two-port technique, we conducted a study in which 280 patients with palpable left varicoceles were treated with spermatic vein ligation either by open surgery (120 patients) ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1996.10.435
更新日期:1996-10-01 00:00:00
abstract:PURPOSE:We aimed to understand the characteristics of patients who are less likely to submit adequate urine collections at metabolic stone evaluation. METHODS:Inadequate urine collection was defined using two definitions: (1) Reference ranges for 24-hour creatinine/kilogram (Cr/24) and (2) discrepancy in total 24-hour...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0544
更新日期:2015-06-01 00:00:00
abstract:: Introduction: This exploratory retrospective analysis examined any potential prognostic role of preoperative neutrophil lymphocyte ratio (NLR) for progression-free survival (PFS) and time to endoscopically verified upper tract or bladder recurrence-free survival (RFS) in u...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0283
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:It is known that extracorporeal shock wave lithotripsy (SWL) may be improved by increasing cavitation using tandem shock waves. However, fluid is needed for the cavitation to work. The purpose of this research was to evaluate the importance of a fluid-filled expansion chamber in enhancing stone f...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2008.0334
更新日期:2009-04-01 00:00:00
abstract:PURPOSE:To present our preliminary experience with laparoscopic renal cryoablation in patients with small renal tumors and severe comorbidities. PATIENTS AND METHODS:Eight patients with a mean age of 75.6 years (range 68-82 years) who had small (mean 2.6+/-0.7-cm; range 1.4-3.8-cm) peripheral renal cortical lesions an...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277903767923227
更新日期:2003-08-01 00:00:00
abstract::This is a case report of a 37-year-old man with severe testicular pain unresolved after conventional investigative and therapeutic methods. On the basis of his history of abdominal trauma followed by emergency splenectomy and evidence of functioning splenic tissue on a radionuclide scan, the diagnosis of splenosis was...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1999.13.373
更新日期:1999-06-01 00:00:00
abstract:INTRODUCTION:Routine preoperative electrocardiogram (ECG) before shockwave lithotripsy (SWL) is frequently performed despite recommendations against its use in asymptomatic patients undergoing low-risk surgical procedures. This study assesses whether routine preoperative ECG before SWL is useful in patients at low risk...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2019.0053
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:This study aims to provide an overview of type and frequency of musculoskeletal complaints among urologists. In addition, the urologists' knowledge about ergonomic conditions during minimally invasive urology was assessed, and they were asked how they would prefer to gain knowledge about this topic. MATERIALS ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0654
更新日期:2014-05-01 00:00:00
abstract:PURPOSE:Safe insertion of the first port during laparoscopic surgery has always been problematic, from the early use of the Veress needle to the open Hasson technique. We describe a novel, safe, and well-illuminated technique of port entry using the Killian nasal speculum. This technique has been used successfully in t...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.0142
更新日期:2008-02-01 00:00:00