title: Application of failure mode and effect analysis in laparoscopic colon surgery training.
abstract: OBJECTIVE
  To evaluate if application of failure mode and effect analysis (FMEA) to laparoscopy training can help surgeons acquire laparoscopy skills.
  
  
  METHODS
  After preparing a FMEA matrix of laparoscopic sigmoidectomy, we have introduced it during three laparoscopy courses. Forty-eight surgeons, divided into 24 teams of two surgeons, have participated in three courses. During each course, every team has performed three laparoscopic sigmoidectomies in three experimental animals (1 OR session every day). Risk priority number (RPN) has been calculated for every surgery, and the results have been discussed at the end of each training day with all participants.
  
  
  RESULTS
  We have observed a decline in the median RPN from 1339 during the first OR session through 62 during second OR session to reach 0 in the third OR session. Only two teams out of 24 were not able to reach a RPN of less than 300 during third OR session. When the type of failures were analysed, we have observed a shift from procedure-type failures to technical failures that depended on each participant technical abilities.
  
  
  CONCLUSIONS
  Application of FMEA principles to laparoscopy training can help acquire non-technical skills necessary for safe laparoscopic surgery.
authors.affiliation: Consorcio Sanitario Publico del Aljarafe, Hospital San Juan de Dios, Bormujos, Sevilla, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Alba Mesa
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Sanchez Hurtado
authors.forename: Francisco Miguel
authors.initials: FM
authors.lastname: Sanchez Margallo
authors.forename: Virginia
authors.initials: V
authors.lastname: Gomez Cabeza de Vaca
authors.forename: Andrzej L
authors.initials: AL
authors.lastname: Komorowski
mesh_terms: D000818:Animals; D002983:Clinical Competence; D012809:Colon, Sigmoid / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000193:education; D004521:Educational Measurement / Q000379:methods*; D005246:Feedback; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D023421:Models, Animal; D013552:Swine; D013663:Teaching / Q000379:methods*