Abstract
Background
Despite the widespread use of surgical energy devices and the potential for rare but serious complications, pilot data from North America suggest that surgeons and surgical trainees have knowledge gaps in their safe use. The purpose of this study was to determine baseline knowledge of general surgeons and surgical trainees regarding the safe use of electrosurgery (ES) across varying levels of experience in Japan.
Methods
Participants completed a 35-item multiple-choice question examination, testing critical knowledge of ES. The examination was developed according to the objectives and blueprints of SAGES’ Fundamental Use of Surgical Energy™ curriculum. Sections of the examination included: “principles of ES,” “ES-related adverse events,” “monopolar and bipolar devices,” and “pediatric considerations and interference with implantable devices.” Scores were compared between PGY > 5 and PGY 1–5 participants.
Results
A total of 145 general surgeons and surgical trainees of all years after medical school (PGY 1–5: 57, PGY > 5: 88) from ten academic and five community hospitals completed the assessment (mean age 35; 91 % male). The mean score in the entire cohort was 58 ± 12 % (range 23–83 %), with significantly higher scores in the PGY > 5 group compared to the PGY 1–5 group (60 ± 11 vs. 53 ± 12 %, p < 0.01). Among all participants, 92 % were not familiar with best practices when using ES on patients with a pacemaker; 44 % believe that ES uses thermal energy from cautery; 19 % did not know how to manage an operating room fire; 16 % thought that a dispersive electrode should be cut to fit a child; and 27 % believe that insulation failure in minimally invasive surgical instruments is mostly visible under careful inspection.
Conclusions
General surgeons and trainees at all levels have knowledge gaps in the safe and effective use of energy devices, regardless of years of experience. There is a need for educational curricula to help address these gaps and contribute to safer surgery.
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Acknowledgments
The authors thank Ayumi Takahashi for finalizing the translation of the examination. We acknowledge Dr. Takeyoshi Yumiba and Dr. Yoshio Yamasaki at JCHO Osaka Hospital; Dr. Hiroyasu Kano at Kameta Memorial Center; and Dr. Shunichi Okushiba and Dr. Hiroyuki Kato at KKR Tonan Hospital for their contributions to this multicenter project. We would also like to acknowledge all participants. Without the generosity of all of the participants, this study would have been not possible.
Conflict of interest
Drs. Yusuke Watanabe, Yo Kurashima, Amin Madani, Liane S. Feldman Akihiko Oshita, Takeshi Naitoh, Kazuhiro Noma, Keigo Yasumasa, Hiroshi Nagata, Fumitaka Nakamura, Koichi Ono, Yoshinori Suzuki, Nobuhisa Matsuhashi, Toshiaki Shichinohe, Satoshi Hirano, and Minoru Ishida have nothing to disclose.
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Watanabe, Y., Kurashima, Y., Madani, A. et al. Surgeons have knowledge gaps in the safe use of energy devices: a multicenter cross-sectional study. Surg Endosc 30, 588–592 (2016). https://doi.org/10.1007/s00464-015-4243-5
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DOI: https://doi.org/10.1007/s00464-015-4243-5