Team dynamics in emergency surgery teams: results from a first international survey

Background: Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with no awareness of the trauma\u2019s causes or the patient\u2019s personal and clinical information. In this perspective, the dynamics of how trauma teams function is fundamental to ensuring the best performance and outcomes. Methods: An online survey was conducted among the World Society of Emergency Surgery members in early 2021. 402 fully filled questionnaires on the topics of knowledge translation dynamics and tools, non-technical skills, and difficulties in teamwork were collected. Data were analyzed using the software R, and reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results: Findings highlight how several surgeons are still unsure about the meaning and potential of knowledge translation and its mechanisms. Tools like training, clinical guidelines, and non-technical skills are recognized and used in clinical practice. Others, like patients\u2019 and stakeholders\u2019 engagement, are hardly implemented, despite their increasing importance in the modern healthcare scenario. Several difficulties in working as a team are described, including the lack of time, communication, training, trust, and ego. Discussion: Scientific societies should take the lead in offering training and support about the abovementioned topics. Dedicated educational initiatives, practical cases and experiences, workshops and symposia may allow mitigating the difficulties highlighted by the survey\u2019s participants, boosting the performance of emergency teams. Additional investigation of the survey results and its characteristics may lead to more further specific suggestions and potential solutions

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Concomitant cranio-spinal trauma: additional risk from a cerebrovascular injury

Scientific Assessment and Innovation in Neurosurgical Treatment Strategie

Postural ergonomics and work-related musculoskeletal disorders in neurosurgery: lessons from an international survey

Background: Work-related musculoskeletal disorders (WMSDs) affect a significant percentage of the neurosurgical workforce. The aim of the current questionnaire-based study was to examine the prevalence of WMSDs amongst neurosurgeons, identify risk factors, and study the views of neurosurgeons regarding ergonomics. Methods: From June to August 2020, members of the “European Association of Neurosurgical Societies,” the “Neurosurgery Research Listserv,” and the “Latin American Federation of Neurosurgical Societies” were asked to complete an electronic questionnaire on the topics of WMSDs and ergonomics. Results: A total of 409 neurosurgeons responded to the survey, with a 4.7 male to female ratio. Most of the surgeons worked in Europe (76.9%) in academic public hospitals. The vast majority of the participants (87.9%) had experienced WMSDs, mainly affecting the shoulder, neck, and back muscles. The most common operations performed by the participants were “Craniotomy for convexity/intrinsic tumors” (24.1%) and “Open lumbar basic spine” (24.1%). Neurosurgeons agreed that ergonomics is an underexposed area in the neurosurgical field (84.8%) and that more resources should be spend (87.3%) and training curricula changes should be made (78.3%) in order to alleviate the burden of WMSDs on neurosurgeons. Univariate analysis did not reveal any associations between the development of WMSDs and age, gender, tenure, average duration of operation, operating time per week, type of operation, and surgical approach. Conclusions: The problem of WMSDs ought to be more closely addressed and managed by the neurosurgical community. More studies ought to be designed to investigate specific ergonomic parameters in order to formulate practice recommendations. © 2021, The Author(s)

The Impact of the Coronavirus Pandemic on European Neurosurgery Trainees

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has placed tremendous strain on the national health care systems throughout Europe. As a result, there has been a significant influence on residents' education. We surveyed European neurosurgery residents to estimate the magnitude of the pandemic's impact on neurosurgical training. Methods: An anonymous, voluntary, 44-question, web-based survey was administered to European neurosurgical residents from November 2, 2020, to January 15, 2021, by e-mail invitation. Close-ended, multiple-choice questions were used to examine the perspectives of neurosurgical trainees of different training programs in Europe regarding the pandemic's impact on education, as well as to evaluate the online webinars as a sufficient alternative educational tool, and their future role. Results: The total number of participants was 134 from 22 European countries. Nearly 88.8 % of respondents reported that the pandemic had a negative influence on their education. A statically significant decrease in surgical exposure, outpatient clinic involvement, and working hours was observed (P < 0.05). Webinars, although widely disseminated, were not considered as a sufficient training alternative. Conclusions: The SARS-CoV-2 pandemic had a significant impact on neurosurgical training. During the last year, with the outbreak of the pandemic, formal training education was heavily compromised. Online webinars do not seem to be a sufficient alternative, and some trainees estimate that a whole year of training has been compromised. Our current data have to be cautiously considered for possibly reorganizing the whole training experience. The pandemic may well function as a stimulus for optimizing neurosurgical training. © 2021 The Author

Diversity and equality in neurosurgery

Scientific Assessment and Innovation in Neurosurgical Treatment Strategie