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Cognitive Assessment of Surgeons During Surgical Procedures: Influence of Time and Intraoperative Complications

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Abstract

Introduction

Surgeon’s performance may be influenced by several factors that may affect skills and judgement, which ultimately represents surgeon´s cognition. Cognition refers to all forms of knowing and awareness, such as perceiving, conceiving, remembering, reasoning, judging, imagining, and problem solving. This report aims to evaluate the effect of operative time and operative complications on surgeon´s cognition.

Methods

Forty-six surgeons (mean age 31 years, 78% males) assigned to an operation expected to last for at least 2 h, volunteered for the study. All participants underwent 3 cognitive tests at the beginning of the operation and hourly, until the end of the procedure: (a) concentration (serial sevens, counting down from 100 by sevens); (b) visual (fast counting, counting the number of circles with the same color among a series of circles); and (c) motor (trail making, connecting a set of numbered dots). Intraoperative complications were recorded.

Results

The visual test had a stable behavior along time. Concentration and motor tests tend to be performed faster. Intraoperative complications occurred in 5 (11%) cases (3 hemorrhage and 2 organ injuries). Performance time was stable for concentration and motor tests but visual test tends to be performed faster in cases with an intraoperative complication.

Conclusion

Our results showed that (1) time does not jeopardize surgeons’ cognition, but rather surgeons learned to perform the tests faster, and (2) complications do not decrease surgeons’ cognition.

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Authors and Affiliations

  1. Department of Surgery, Escola Paulista de Medicina, Rua Diogo de Faria 1087, cj 301, São Paulo, SP, 04037-003, Brazil

    Juliana Beneduzzi & Fernando A. M. Herbella

  2. University of North Carolina at Chapel Hill, Chapel Hill, USA

    Francisco Schlottmann & Marco G. Patti

Authors
  1. Juliana Beneduzzi
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  2. Fernando A. M. Herbella
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  3. Francisco Schlottmann
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  4. Marco G. Patti
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Contributions

JB contributed to protocol/project development; data collection or management; data analysis; and manuscript writing/editing. FAMH involved in protocol/project development; data collection or management; data analysis; and manuscript writing/editing. FS and MGP performed manuscript writing/editing.

Corresponding author

Correspondence to Fernando A. M. Herbella.

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Beneduzzi, J., Herbella, F.A.M., Schlottmann, F. et al. Cognitive Assessment of Surgeons During Surgical Procedures: Influence of Time and Intraoperative Complications. World J Surg 43, 143–148 (2019). https://doi.org/10.1007/s00268-018-4764-x

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  • DOI: https://doi.org/10.1007/s00268-018-4764-x

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