Surgical Innovation Lab

Our Research Projects

Midurethral Sling Surgery Errors

We hypothesize that surgical error related to sub-optimal surgeon bio-mechanics can be quantified, predicted, and avoided by discrete changes in the kinematics of the surgeon’s shoulder, elbow, and wrist, and the surgical instrument’s spatio-temporal characteristics.

Beeps, Squeals, and Drones

A cross-sectional study measuring noise and conversation in the OR. We use sound recordings from various OR environments to crease a replication soundscape of the various sounds that occur in a live OR. We also use case-relevant conversations among surgical team members to create a perception performance test.

Health Facts

A qualitative analysis of health data in different areas as they relate to surgical procedures and their outcomes.

Induction of general anesthesia sequence (IGAS) study: Unpacking expertise, judgement cues, and critical decision making during high priority events

Qualitative study using cognitive task analysis to elicit tacit domain knowledge from anesthesia personnel about tasks within induction of anesthesia that are typified by high time pressure, high information content, and changing conditions. We focus on 2 critical steps within induction of anesthesia: mask ventilation and direct laryngoscopy. Our overall goal is to create a graphic flowchart that lists key judgement and decision points, informed by environmental cued that made by experts during our 2 critical tasks.

Movement Analysis

We wish to study how non-verbal communication patterns between the attending surgeon and resident surgeon influences resident autonomy during critical moments of the surgery. To study this, we audio and video record both attending and resident surgeons in the OR. We also use a mixed-methods approach to gather as much data as possible.

Scoping Review

Review of scoping studies that use video in the OR.

Cognitive Strategies in High Risk Surgical Steps: The Role of Coping and Resilience

Qualitative study that explores the mental responses of surgeons during high risk surgical steps, how they develop strategies to alleviate stress and perform under pressure, how they perform under pressure without choking, and how performance under pressure is related to cognitive map formation and manipulation. We explore these themes through semi-structured interview in order to identify trends in strategies for coping and resilience that surgeons use to improve their performance.

Surgical Ethnography

We are examining the lived experience of the surgical theater. There are some examples listed at the bottom of the page, under the Manuscript Phase Section.

Anterior Colpotomy

A descriptive study that aims to provide insight into the techniques that are used by expert surgeons when performing vaginal hysterectomies. Utilizes video recordings during vaginal hysterectomy surgeries to identify, at the smallest visible level, the correct plane during the anterior colpotomy surgical step. Video and audio recording are also utilized in semi-structured interviews of expert surgeons to identify themes relating to visual and haptic clues found in the anterior colpotomy step of vaginal hysterectomies.

 

Research Projects in the Manuscript Phase

 

Pursuit of Error-Free Surgery

We are analyzing different themes related to surgical teaching and the avoidance of error.

Mechanisms of Injury in the Midurethral Sling Surgery

Interviews with surgeons about the most common mechanisms of injury in the midurethral sling surgery.

Midurethral Sling Cognitive Task Analysis

We are collaborating with investigators at the University of Pittsburgh to perform a cognitive task analysis on portions of the midurethral sling surgery. We plan to isolate the steps that are the most difficult to learn so appropriate teaching strategies may be developed.

Mesh Exposure

Investigation of the factors that cause mesh exposure in the midurethral sling surgery.

Ambiguous Language in the Operating Room (Deixis)

We aim to study the verbal and physical communication between attending and resident surgeons in order to identify the prevalence of ambiguous language use and potential miscommunications.

Surgical Errors in the TVT Surgery

Objective is to describe surgical errors in the MUS surgery according to the surgeon’s verbal description and also their physical hand motions and body positions. In interviews we ask surgeons to hypothesize how individual surgeon error contributes to MUS injuries. We will use these interview responses to generate theories about surgeon body position and hand motion related to these surgical errors.

Surgical Ethnography projects in the manuscript phase

Silence in the Operating Room