title: Risk factors in patient safety: minimally invasive surgery versus conventional surgery.
abstract: BACKGROUND
  This study aimed to identify the frequency of events in the different patient safety risk domains during minimally invasive surgery (MIS) and conventional surgery (CS).
  
  
  METHODS
  A convenience sample of gynecologic MIS and CS was observed. Events were observed and categorized into one of the predefined patient safety risk domains.
  
  
  RESULTS
  A total of 53 procedures were observed: 26 CS and 27 MIS procedures. The general characteristics were comparable between the two groups. A large number of environmental events were observed, averaging one every 2.5 min. Technical events and events of an organizational nature occurred more often in MIS (P < 0.01) than in CS (P < 0.01). The relative risk for the occurrence of one or more technical events in MIS compared with CS was 1.7, and the risk for two or more technical events was 4.1. A time out according to protocol showed no relationship to the occurrence of the different types of patient safety-related events.
  
  
  CONCLUSIONS
  The technological complexity inherent in MIS makes this type of surgery more prone to technology-related problems than CS, even in a specially designed minimally invasive surgical suite. A regular time-out procedure developed for CS lacks the attention necessary for the complex technology used in MIS and therefore is insufficient for MIS procedures briefing. Incorporating a specially designed technology checklist in a regular briefing protocol could be a solution to decrease the number of events in MIS.
authors: Department of Gynecology, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, The Netherlands. S.P.Rodrigues@lumc.nl
authors: Sharon P
authors: SP
authors: Rodrigues
authors: Aurystella M
authors: AM
authors: Wever
authors: Jenny
authors: J
authors: Dankelman
authors: Frank W
authors: FW
authors: Jansen
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D019300:Medical Errors / Q000706:statistics & numerical data; D009426:Netherlands; D061214:Patient Safety / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors