The effect of a performance based intra-procedural checklist on a simulated emergency laparoscopic task in novice surgeons

Michael El Boghdady (Lead / Corresponding author), Benjie Tang, Afshin Alijani

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
431 Downloads (Pure)


Surgical checklists are in use as means to reduce errors. Checklists are infrequently applied during emergency situations in surgery. We aimed to study the effect of a simple self-administered performance-based checklist on the laparoscopic task when applied during an emergency-simulated scenario. The aviation checklist for unexpected situations is commonly used for simulated training of pilots to handle emergency during flights. This checklist was adopted for use as a standardised-performance-based checklist during emergency surgical tasks. Thirty consented laparoscopic novices were exposed unexpectedly to a bleeding vessel in a laparoscopic virtual reality simulator as an emergency scenario. The task consisted of using laparoscopic clips to achieve haemostasis. Subjects were randomly allocated into two equal groups; those using the checklist that was applied once every 20 s (checklist group) and those without (control group). The checklist group performed significantly better in 5 out of 7 technical factors when compared to the control group: right instrument path length (m), median (IQR) 1.44 [1.22] versus 2.06 [1.70] (p = 0.029), right instrument angular path (degree) 312.10 (269.44 versus 541.80 [455.16] (p = 0.014), left instrument path length (m) 1.20 [0.60] versus 2.08 [2.02] (p = 0.004), and left instrument angular path (degree) 277.62 [132.11] versus 385.88 [428.42] (p = 0.017). The checklist group committed significantly fewer number of errors in the application of haemostatic clips, 3 versus 28 (p = 0.006). Although statistically not significant, total blood loss (lit) decreased in the checklist group from 0.83 [1.23] to 0.78 [0.28] (p = 0.724) and total time (sec) from 186.51 [145.69] to 125.14 [101.46] (p = 0.165). The performance-based intra-procedural checklist significantly enhanced the surgical task performance of novices in an emergency-simulated scenario.
Original languageEnglish
Pages (from-to)2242-2246
Number of pages5
JournalSurgical Endoscopy
Issue number5
Early online date1 Sept 2016
Publication statusPublished - May 2017


  • Checklist
  • Laparoscopic
  • Surgery
  • Emergency
  • Training
  • Simulation
  • Task performance


Dive into the research topics of 'The effect of a performance based intra-procedural checklist on a simulated emergency laparoscopic task in novice surgeons'. Together they form a unique fingerprint.

Cite this