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Factors affecting surgical dexterity in novice and experienced vitreoretinal surgeons

Dicas para melhora da destreza cirúrgica

Marina Roizenblatt1,2,3; Peter L. Gehlbach3; Vitor D. G. Marin1; Arnaldo Roizenblatt1; Vinicius da S. Saraiva1,2; Mauricio H. Nakanami1; Luciana da C. Noia1; Sung E. S. Watanabe1; Erika S. Yasaki1; Renato M. Passos1,2; Octaviano Magalhães Junior1; Rodrigo A. B. Fernandes4; Francisco R. Stefanini1; Rafael Caiado1; Kim Jiramongkolchai5; Michel E. Farah1,2; Rubens Belfort Junior1,2; Mauricio Maia1,2

DOI: 10.17545/eOftalmo/2024.0007

Novice and experienced vitreoretinal surgeons were evaluated after being exposed to the following variables: caffeine, propranolol, alcohol, exercise, and sleep deprivation. Multiple comparisons have indicated the importance of these external and potentially modifiable variables in improving the surgical skills of ophthalmologists with different levels of experience.

On different non-consecutive days of the study, tasks were performed using the Eyesi simulator, 30-40 min after exposure to weight-adjusted doses of caffeine, propranolol, and alcohol as measured using a breathalyzer. Furthermore, the surgeons were instructed to perform push-ups until exhaustion. Finally, a night of sleep deprivation, with a total time in bed of 3 h, was recorded by polysomnogram.

As compared to the baseline, the results of our study indicated that novice surgeons performed worse after consuming weight-adjusted doses of coffee or alcohol1-3. Moreover, after consuming alcohol, novice surgeons performed a longer intraocular pathway to complete the tasks and experienced more tremor. Furthermore, sleep deprivation negatively affected the duration of the tasks and caused increased tremor among novice surgeons4, while consumption of propranolol increased the surgical speed2,3. The scores of experienced surgeons only deteriorated after alcohol consumption.

 

 

REFERENCES

1. Roizenblatt M, Jiramongkolchai K, Gehlbach PL, Marin VDGB, Grupenmacher AT, Muralha F, et al. A multifactorial approach for improving the surgical performance of novice vitreoretinal surgeons. Retina. 2021;41(10):2163-2171.

2. Roizenblatt M, Gehlbach PL, Saraiva VS, Nakanami MH, Noia LC, Eatanabe SES, et al. Weight-adjusted caffeine and β-blocker use in novice versus senior retina surgeons: a self-controlled study of simulated performance. Eye (Lond). 2023;37(14):2909-2914.

3. Roizenblatt M, Marin VDGB, Grupenmacher AT, Muralha F, Faber J, Jiramongkolchai K, et al. Association of Weight-Adjusted Caffeine and β-Blocker Use With Ophthalmology Fellow Performance During Simulated Vitreoretinal Microsurgery. JAMA Ophthalmol. 2020 Aug 1;138(8):819-825.

4. Roizenblatt M, Gehlbach PL, Marin VDG, Eoizenblatt A, Saraiva VS, Nakanami MH, et al. A Polysomnographic Study of Effects of Sleep Deprivation on Novice and Senior Surgeons during Simulated Vitreoretinal Surgery. Ophthalmol Retina. 2023;7(11):940-947.

 

AUTHORS INFORMATIONS

» Marina Roizenblatt
https://orcid.org/0000-0003-2191-4242
http://lattes.cnpq.br/2958911741191259
» Peter L. Gehlbach
https://orcid.org/0000-0002-9608-9171
» Vinicius da S. Saraiva
https://orcid.org/0009-0008-0186-8465
http://lattes.cnpq.br/4252772710113392
» Luciana da C. Noia
https://orcid.org/0000-0003-2674-051X
http://lattes.cnpq.br/7297139417211310
» Erika S. Yasaki
https://orcid.org/0000-0002-7685-6011
http://lattes.cnpq.br/2644154071535991
» Vitor D. G. Marin
https://orcid.org/0000-0002-3840-2027
http://lattes.cnpq.br/8100784211158730
» Arnaldo Roizenblatt
https://orcid.org/0000-0003-4035-0622
http://lattes.cnpq.br/8775548329523815
» Mauricio H. Nakanami
https://orcid.org/0009-0007-0394-8840
» Sung E. S. Watanabe
https://orcid.org/0000-0001-6553-8117
http://lattes.cnpq.br/3528644527985185
» Renato M. Passos
https://orcid.org/0000-0003-0439-5495
http://lattes.cnpq.br/4616475766242590
» Octaviano Magalhães Junior
https://orcid.org/0009-0005-3102-224X
http://lattes.cnpq.br/4598915786843339
» Rodrigo A. B. Fernandes
https://orcid.org/0000-0002-0274-0315
http://lattes.cnpq.br/2464239247246843
» Kim Jiramongkolchai
https://orcid.org/0000-0003-2658-9872
» Rubens Belfort Junior
https://orcid.org/0000-0002-8422-3898
http://lattes.cnpq.br/4270399167335564
» Francisco R. Stefanini
https://orcid.org/0000-0002-7099-996X
http://lattes.cnpq.br/3018399731049618
» Rafael Caiado
https://orcid.org/0000-0002-9311-233X
http://lattes.cnpq.br/4121234813204182
» Michel E. Farah
https://orcid.org/0000-0001-5951-0193
http://lattes.cnpq.br/1907009763960478
» Mauricio Maia
0000-0002-7034-8091
http://lattes.cnpq.br/637710574423186

 

 

Funding: The authors declare that they received no funding.

Conflicts of interest: The authors declare no conflicts of interest.

Received on: March 25, 2024.
Accepted on: March 27, 2024.


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