Saturday, August 30, 2014

A Black Box for the Operating Room


Surgical 'black box' could reduce errors According to Dr. Chethan Sathya, Special to CNN ;


Airliners have them, trains have them, and now,even automobiles have them. How many 

times have we heard about the search for the black box?

It may be coming to an operating room near you.


Researchers in Canada have created a surgical "black box" that tracks surgeons' movements during an operation



  So far, Grantcharov's black box has been tested on about 40 patients undergoing laparoscopic weight-loss surgery.  Teodor Grantcharov, a minimally invasive surgeon at St. Michael's Hospital in Toronto. Unlike the so-called black boxes in aviation, which are used after disasters occur, the surgical black box Grantcharov is creating will be used proactively to prevent major patient complications.

 Inside the operating room, video cameras track every movement. Outside, a small computer-like device analyzes the recordings, identifying when mistakes are made and providing instant feedback to surgeons as they operate.


A work in progress
Grantcharov's black box is a multifaceted system. In addition to the actual box, it includes operating room microphones and cameras that record the surgery, the surgeon's movements and details about team dynamics.
It will allow surgeons to hone in on exactly what went wrong and why.
The black box will eventually assess everything from how surgeons stitch to how delicately they handle organs and communicate with nurses during high-stress situations. Error-analysis software within the black box will help surgeons identify when they are "deviating" from the norm or using techniques linked to higher rates of complications.
So far, Grantcharov's black box has been tested on about 40 patients undergoing laparoscopic weight-loss surgery.
The surgical black box will be tested in hospitals in Canada, Denmark and parts of South America in the next few months. Talks are also under way with a number of American hospitals.
If doctors accept it, implementation in U.S. hospitals could happen quickly since the surgical black box isn't considered a medical device and doesn't require approval from the U.S. Food and Drug Administration.
But the litigious medical environment may make its implementation problematic. If the recordings were used in court, they could open the floodgates to a new wave of malpractice concerns, which would be counterproductive to surgeons and patients, Grantcharov says.
"We have to ensure the black box is used as an educational tool to help surgeons evaluate their performance and improve," he says.
Bottom line, Grantcharov says, is that even after years of practicing medicine, the black box "made me a safer surgeon and a better teacher."













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