Intraoperative Verbal Communication in Pediatric Single-Incision Laparoscopic Percutaneous Extraperitoneal Closure: A...

Area of Science:

• Pediatric Surgery
• Surgical Education
• Medical Communication

Background:

• Declining case volumes and work hour restrictions necessitate efficient pediatric surgical training.
• The operating room is a key learning environment, but intraoperative teaching methods require clarification.
• Understanding verbal communication patterns is crucial for optimizing surgical training.

Purpose of the Study:

• To examine the educational role of intraoperative verbal communication in pediatric surgery.
• To identify specific communication patterns during single-incision laparoscopic procedures.
• To uncover opportunities for improving surgical training through enhanced communication strategies.

Main Methods:

• Retrospective analysis of audio-video recordings from unilateral single-incision laparoscopic percutaneous extraperitoneal closure procedures.
• Verbal statements were transcribed, classified by type and content, and analyzed for frequency and distribution.
• Communication patterns between attending and operating surgeons were assessed, focusing on debriefing during wound closure.

Main Results:

• Nineteen cases provided 7374 statements, with 'General' topics being most frequent, followed by 'Instrument handling', 'Anatomy', and 'Operation method'.
• Instrument handling communication increased during laparoscopic manipulation (27.1%), while 'Private talk' rose during wound closure (18.5%).
• Attending-to-operating surgeon communication peaked during laparoscopic manipulation, with frequent 'Commanding' and 'Advising' statements; intraoperative debriefing occurred in only 10.5% of cases.

Conclusions:

• Intraoperative communication during these procedures exhibits distinct phase-specific characteristics.
• Directive teaching is prevalent during laparoscopic phases, contrasting with limited reflective debriefing.
• Systematic integration of debriefing in the wound closure phase could enhance reflective learning and overall educational impact.