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Effects of exogenous factors on spatial accuracy in neurosurgery
Affiliation:2. Department of Biomedical Informatics and Artificial Intelligence, N.N. Burdenko National Medical Research Center of Neurosurgery, Moscow 125047, Russia;1. Department of Neurosurgery, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia;2. Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA;1. Hospital Madre Teresa, Belo Horizonte, MG, Brazil;2. Hospital Municipal Miguel Couto, Rio de Janeiro, RJ, Brazil;3. University of Vanderbilt, School of Medicine, Nashville, TN, USA;4. Universidade Federal Fluminense, Rio de Janeiro, RJ, Brazil;1. The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 510120 Guangzhou, Guangdong, China;2. Guangzhou University of Chinese Medicine, 510405 Guangzhou, Guangdong, China;3. University at Buffalo, The State University of New York, 14228 Buffalo, NY, USA;4. Guangxi University of Chinese Medicine, 530299 Nanning, Guangxi, China;5. The First Affiliated Hospital of Guangxi University of Chinese Medicine, 530023 Nanning, Guangxi, China;1. Department of Head & Neck Surgery, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, United States;2. Department of Neurosurgery, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, United States;3. Department of Radiation Oncology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, United States;4. Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, United States;5. Department of Neurosurgery, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, United States;6. Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, United States
Abstract:
The study aimed to assess the effect of exogenous factors such as surgeon posture, surgical instrument length, fatigue after a night shift, exercise and caffeine consumption on the spatial accuracy of neurosurgical manipulations. For the evaluation and simulation of neurosurgical manipulations, a testing device developed by the authors was used. The experimental results were compared using nonparametric analysis (Wilcoxon test) and multivariate analysis, which was performed using mixed models. The results were considered statistically significant at p < 0.05. The study included 11 first-year neurosurgery residents who met the inclusion criteria. Hand support in the sitting position (Wilcoxon test p value = 0.0033), caffeine consumption (p = 0.0058) and the length of the microsurgical instrument (p = 0.0032) had statistically significant influences on the spatial accuracy of surgical manipulations (univariate analysis). The spatial accuracy did not significantly depend on the type of standing position (Wilcoxon test p value = 0.2860), whether the surgeon was standing/sitting (p = 0.1029), fatigue following a night shift (p = 0.3281), or physical exertion prior to surgery (p = 0.2845).When conducting the multivariate analysis, the spatial accuracy significantly depended on the test subject (p < 0.0001), the use of support during the test (p = 0.0001), and the length of the microsurgical instrument (p = 0.0397). To increase the spatial accuracy of microsurgical manipulations, hand support and shorter tools should be used. Caffeine consumption in high doses should also be avoided prior to surgery.
Keywords:Microsurgery  Surgical manipulation accuracy  Caffeine  Physical activity  Hand support  Night shift
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