Surgical Innovation Lab

Our Research Projects

Deixis

The use of ambiguous language and its effect on learning. “Semantically Ambiguous Language in the Teaching Operating Room” is a result of this research.

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. Some of the articles below are results of this research, including, “The Risk of Primary Uterine and Cervical Cancer After Hysteropexy” and  “Risk Factors for Returning to the OR for a Second Surgery After Midurethral Sling for Stress Urinary Incontinence

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

Scoping review of studies that use video-recording as a methodology to conduct Health Professions Education research. This research is a collaborative effort with external researchers   Elizabeth Littleton,  Emily Huang, and Patricia O’Sullivan.

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. Some of the articles below are results of this research, namely “Absence or Presence: Silent Discourse in the Operating Room and Impact on Surgical Team Action” and “An Ethnographic Study Examining Attending Surgeon Persona in the Operating Room and Influence on Interprofessional Team Action

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.

 

Published Manuscripts

 

Lavelle ES, Alam P, Meister M, Florian-Rodriguez M, Elmer-Lyon C, Kowalski J, Carter-Brooks C, Mazloomdoost D, Zyczynski H, Lowder J, Gutman R, Sutkin G. Antibiotic Prophylaxis During Catheter-Managed Postoperative Urinary Retention After Pelvic Reconstructive Surgery: A Randomized Controlled Trial. Obstetrics and Gynecology. 2019;134(4). doi:10.1097/AOG.0000000000003462. PMID: 31503155.

Sutkin G. Pelvic Anatomy Terminology: Can We Agree to Agree? Am J Obstet Gynecol. 2020 Mar;222(3):199-200. doi:10.1016/j.ajog.2020.01.008. PMID: 32122534.

Sharif F, Mahmud F, Suman S, Cheng, A-L, Shepherd J, Sutkin G Risk Factors for Returning to the OR for a Second Surgery After Midurethral Sling for Stress Urinary Incontinence. Female Pelvic Med Reconstr Surg. 2020 Jul;26(7):443-446. doi:10.1097/SPV.0000000000000804. PMID: 32217917.

Brommelsiek M, Kanter SL, Sutkin G. An Ethnographic Study Examining Attending Surgeon Persona in the Operating Room and Influence on Interprofessional Team Action. Journal of Interprofessional Education & Practice. September 2020;20 doi:10.1016/j.xjep.2020.100359.

Sutkin G, Littleton EB, Arnold L, Kanter SL. Micro-relational interdependencies are the essence of teaching and learning in the OR. Med Educ. 2020 Dec;54(12):1137-1147. doi:10.1111/medu.14353 Epub 2020 Sep 9. PMID: 32794212.

Brommelsiek M, Said T, Gray M, Kanter SL, Sutkin G. Absence or Presence: Silent Discourse in the Operating Room and Impact on Surgical Team Action [published online ahead of print, 2020 Sep 19]. Am J Surg. 2020;S0002-9610(20)30586-9. doi:10.1016/j.amjsurg.2020.09.017

Kanjilal D, Mahmud F, Sutkin G. Constructivist Grounded Theory to Establish the Relationship Between Technical Error and Adverse Patient Outcome: Modeling Technical Error and Adverse Outcomes. Published Online, The American Surgeon, Nov 2020. doi:10.1177/0003134820952837.

Kurian R, Kirchhoff-Rowald A, Sahil S, Cheng A-L, Wang X, Shepherd J, Sutkin G. The Risk of Primary Uterine and Cervical Cancer After Hysteropexy, Female Pelvic Medicine & Reconstructive Surgery: March 2021(27)3:e493-e496. doi: 10.1097/SPV.0000000000001030.

Liu C, McKenzie A, Sutkin G. Semantically Ambiguous Language in the Teaching Operating Room. J Surg Educ. 2021 Apr 23:S1931-7204(21)00073-8. doi: 10.1016/j.jsurg.2021.03.020. Epub ahead of print. PMID: 33903062.