Evgenii Belykh1, Naomi R Onaka2, Irakliy T Abramov3, Kaan Yağmurlu4, Vadim A Byvaltsev5, Robert F Spetzler4, Peter Nakaj4, Mark C Preul6. 1. Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA; Irkutsk State Medical University, Irkutsk, Russia. 2. University of Arizona College of Medicine, Phoenix, Arizona, USA. 3. N. N. Burdenko Research Institute of Neurosurgery, Moscow, Russia. 4. Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA. 5. Irkutsk State Medical University, Irkutsk, Russia. 6. Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA. Electronic address: Neuropub@barrowneuro.org.
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. METHODS: A literature search of factors that may affect microsurgical performance was conducted using PubMed and Embase. The criteria for inclusion were established in accordance with the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) statement. RESULTS: Forty-eight studies were included in the analysis. Most of the studies used surgeons as participants. 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) β-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 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.
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. METHODS: A literature search of factors that may affect microsurgical performance was conducted using PubMed and Embase. The criteria for inclusion were established in accordance with the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) statement. RESULTS: Forty-eight studies were included in the analysis. Most of the studies used surgeons as participants. 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) β-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 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.
Authors: Felix von Bechtolsheim; Florian Oehme; Michael Maruschke; Sofia Schmidt; Alfred Schneider; Jürgen Weitz; Marius Distler; Sebastian Bodenstedt; Isabel Funke; Stefanie Speidel; Soeren Torge Mees Journal: Surg Endosc Date: 2021-11-15 Impact factor: 3.453
Authors: Evgenii Belykh; Laeth George; Xiaochun Zhao; Alessandro Carotenuto; Leandro Borba Moreira; Kaan Yağmurlu; Baran Bozkurt; Vadim A Byvaltsev; Peter Nakaji; Mark C Preul Journal: Surg Neurol Int Date: 2018-06-04
Authors: Yifan Li; Mitchell D Wolf; Amol D Kulkarni; James Bell; Jonathan S Chang; Amit Nimunkar; Robert G Radwin Journal: Hum Factors Date: 2020-04-14 Impact factor: 2.888