Systematic review of factors influencing surgical performance: Practical recommendations for microsurgical procedures in neurosurgery.

Systematic review of factors influencing surgical performance: Practical recommendations for microsurgical procedures in neurosurgery.

World Neurosurg. 2018 Jan 08;:

Authors: Belykh E, Onaka NR, Abramov IT, Yağmurlu K, Byvaltsev VA, Spetzler RF, Nakaji P, Preul MC

Abstract
BACKGROUND: Microneurosurgical techniques involve complex manual skills and hand-eye coordination that require substantial training. Many factors affect microneurosurgical skills. The goal of this study was to use a systematic evidence-based approach to analyze the quality of evidence for intrinsic and extrinsic factors that influence microneurosurgical performance and to make weighted practical recommendations.
MATERIALS AND METHODS: A literature search of factors that may impact microsurgical performance was conducted using PubMed and Embase. The criteria for inclusion were established in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.
RESULTS: Forty-eight studies were included in the analysis. The majority of the studies used surgeons as subjects. Most used endoscopic surgery simulators to assess skills, and only 12 studies focused on microsurgery. This review provides 18 practical recommendations based on a systematic literature analysis of the following 8 domains: (1) Listening to music before and during microsurgery, (2) caffeine consumption, (3) beta-blocker use, (4) physical exercise, (5) sleep deprivation, (6) alcohol consumption before performing surgery, (7) duration of the operation, and (8) the ergonomic position of the surgeon.
CONCLUSIONS: Despite the clear value of determining the effects of various factors on surgical performance, the available body of literature is limited, and it is not currently possible to determine standards for each surgical field. These recommendations may be used by neurosurgical trainees and practicing neurosurgeons to improve microsurgical performance and acquisition of microsurgical skills. Randomized studies assessing the factors that influence microsurgical performance are required.

PMID: 29325962 [PubMed - as supplied by publisher]

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