Imperial College London
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Mr Daniel Richard Leff

Faculty of Medicine, Department of Surgery & Cancer

Reader in Breast Surgery
 
 
 
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Contact

 

d.leff Website

 
 
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Location

 

016Paterson WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Modi:2020:10.1097/SLA.0000000000004208,
author = {Modi, H and Singh, H and Darzi, A and Leff, D},
doi = {10.1097/SLA.0000000000004208},
journal = {Annals of Surgery},
pages = {648--657},
title = {Multitasking and time pressure in the operating room: impact on surgeons’ brain function},
url = {http://dx.doi.org/10.1097/SLA.0000000000004208},
volume = {272},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective:To  assess  the  impact  of  multitasking and  time  pressure on surgeons’ brain function during laparoscopic suturing.Summary Background Data:Recent neuroimaging evidencesuggests that deterioration in  surgical  performance  under  time  pressure is  associated  with deactivationof  the prefrontal cortex (PFC),an area important for executive functions. However, the effect ofmultitasking on operator brain functionremains unknown.Methods:29surgical residentsperformed  anintracorporealsuturing  task  under fourconditions: 1) self-pacedsuturing,2) time-pressured suturing, 3) self-paced suturingplus decision-making,   and 4) time-pressured   suturing plus   decision-making.   Subjectiveworkload  was  quantified  using  the  Surgical  Task  Load  Index. Technical  skill  was objectively assessed using task progression scores, error scores, leak volumes, and knot tensile strengths. PFC activation was measuredusing optical neuroimaging. Results:Compared with self-paced suturing, subjective workload(au)was significantly greater  in  time-pressuredsuturing  (146.0 vs.  196.0),  suturing  with  decision-making (146.0 vs.182.0),  and  time-pressuredsuturing  with  decision-making  (146.0 vs.227.0). Technical   performance   duringcombined   suturing   and   decision-making   taskswas inferiortosuturing  alone  undertime  pressure orself-paced  conditions(p<0.001).Significant   dorsolateral   PFC   (DLPFC) activations   were   observed during   self-paced suturing,  and  ventrolateral  PFC  (VLPFC) deactivations  were  identified during  time-pressuredsuturing. However, suturing in conjunction withdecision-making resulted in 2significantdeactivation across  boththe VLPFC  and  DLPFC  (p<0.05).  Random  effects regression analysis confirmed decision-making predicts VLPFC and DLPFC deactivation (z=-2.62, p<0.05).Conclusions:Performance degradation during  high  workload  conditions  is  associated with  deactivation  of  prefrontal  regions  important  fo
AU  - Modi,H
AU  - Singh,H
AU  - Darzi,A
AU  - Leff,D
DO  - 10.1097/SLA.0000000000004208
EP  - 657
PY  - 2020///
SN  - 0003-4932
SP  - 648
TI  - Multitasking and time pressure in the operating room: impact on surgeons’ brain function
T2  - Annals of Surgery
UR  - http://dx.doi.org/10.1097/SLA.0000000000004208
UR  - http://hdl.handle.net/10044/1/80519
VL  - 272
ER  -
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