Risk factors in patient safety: minimally invasive surgery versus conventional surgery

Surg Endosc. 2012 Feb;26(2):350-6. doi: 10.1007/s00464-011-1874-z. Epub 2011 Sep 5.


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.

Conclusion: 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.

Publication types

  • Comparative Study

MeSH terms

  • Female
  • Gynecologic Surgical Procedures / adverse effects*
  • Humans
  • Laparoscopy / adverse effects*
  • Medical Errors / statistics & numerical data
  • Netherlands
  • Patient Safety / statistics & numerical data*
  • Risk Assessment
  • Risk Factors