Task Analysis of Laparoscopic and Robotic Procedures

Task analysis of Dundee Jamming with Aberdeen termination
Urology / Mar 13th, 2018 3:36 pm     A+ | a-
External component (starter knot)
1. Take cutting suture (40cm long) with Endoski needle 
2. Make a loop with the shorter limb over the longer limb.
3. Go from below the loop and pull the Non Needle end( Longer Limb)  to create loop within a loop and than tighten it
4. Repeat it, to form another loop within the loop.
5. Insert the Maryland through reducer
6. Hold the both limbs of the loop with the Maryland, hide it in the reducer and insert into abdominal cavity.
Internal component
7. Insert needle holder through another cannula.
8. Hold the needle at the junction of anterior 2/3rd and posterior 1/3rd.
9. Take the first bite (at the angle of the cut peritoneum/ tissue) both cut edges.
10. Pull the needle end till the starter knot touches one of the cut edge.
11. Carefully pass the needle holder through the loop and hold the suture near the needle and pull it through the loop.
12. Tighten it by pulling the needle end of the suture. It gets locked.
13. Then start continuous suturing by making C and taking bites for interlocking. Can do this step without interlocking. 
Termination with Aberdeen’s
14. On the last bite, do not form a C ; without tightening it leave it loose to form a loop.
15. Pass the needle holder through the loop and hold the suture at the exit point of the cut edge and pull the non needle end till its get tighten and the other loop is form. Do not pull the needle out. Again go through the loop and pull the non needle end.  
16. Repeat this again and now pull out the needle through the loop and tighten it.
17. Insert scissors and cut the suture end 1cm.
18. Remove the needle with Maryland.
Dr. Humayra Bint
May 23rd, 2020 3:57 pm
Great Task Analysis everyone should learn how to apply Laparoscopic Intracorporeal Dundee Jamming knot continuous suture with Aberdeen termination.Thanks for sharing.
Dr Nitish Kumar Yadav
May 23rd, 2020 3:59 pm
You are awesome sir. You will occupy a unique position in the history of modern teaching in the field of Laparoscopy Surgery Thanks for posting this Task analysis of Dundee Jamming with Aberdeen termination
Motin (Lunshillong)
May 23rd, 2020 4:17 pm
Beautifully explained with this Task analysis of Dundee Jamming with Aberdeen termination. Thanks for explaining and included all the step! Professor Dr. R. K. Mishra very good academic qualified and well knowledgeable and very talented ! God Bless Him! Thanks for posting.
Dr. Ramya Sanga Reddy
May 23rd, 2020 4:22 pm
It's really Amazing! Everything is clearly discussed with the Task, your way of teaching is just excellent. Thanks uploading this Task analysis of Dundee Jamming with Aberdeen termination. Amazing and informative Task analysis.
Dr. Abubaker Algeria
May 23rd, 2020 4:30 pm
Great Article all Laparoscopic surgeon's should learn how to apply Laparoscopic Intracorporeal Dundee Jamming knot Continuous with Aberdeen termination. The professor is excellent in conveying knowledge and inducing thought. sutures correctly and always keep a suture kit for emergencies.Thanks for posting.
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How to Perform and Implement Task Analysis of Laparoscopic and Robotic Procedures

Task analysis is a critical component of any complex surgical procedure, including laparoscopic and robotic surgeries. It involves breaking down the procedure into its constituent tasks, identifying the steps, skills, and cognitive processes required. Task analysis not only enhances the understanding of these intricate surgeries but also serves as a foundation for training, skill assessment, and continuous improvement in healthcare. In this essay, we will delve into how to conduct and implement task analysis for laparoscopic and robotic procedures.

Task Analysis of Laparoscopic Surgery

Understanding the Significance of Task Analysis

Before we explore the procedure for task analysis, it's essential to recognize why it is of paramount importance in the realm of surgery, particularly for laparoscopic and robotic procedures.

1. Enhanced Learning and Training: Task analysis helps in developing structured training programs. It breaks down complex procedures into manageable components, making it easier for trainees to learn and practice each step methodically.

2. Skill Assessment: By understanding the tasks and sub-tasks involved, it becomes possible to assess the competence of surgeons and surgical teams. This is crucial for ensuring patient safety and quality care.

3. Workflow Optimization: Task analysis can reveal inefficiencies in surgical workflows. Identifying these bottlenecks allows for process improvements, potentially reducing surgical times and enhancing outcomes.

4. Error Reduction: Recognizing potential points of error is vital for preventing surgical complications. Task analysis can highlight critical steps where errors are more likely to occur, leading to proactive measures to mitigate risks.

Procedure for Task Analysis of Laparoscopic and Robotic Procedures:

Task analysis for laparoscopic and robotic procedures involves several steps:

Step 1: Define the Surgical Procedure

Begin by clearly defining the surgical procedure you wish to analyze. Whether it's a laparoscopic cholecystectomy or a robotic prostatectomy, having a specific procedure in mind is essential.

Step 2: Gather Expert Input

Engage experts in the field, including experienced surgeons, nurses, and other surgical team members. Their input is invaluable in identifying and detailing the tasks involved.

Step 3: Identify the Tasks and Sub-Tasks

Break down the surgical procedure into tasks and sub-tasks. For instance, in a laparoscopic cholecystectomy, tasks could include trocar placement, camera insertion, gallbladder dissection, and suturing. Sub-tasks under "trocar placement" might involve choosing trocar sizes, making incisions, and inserting trocars.

Step 4: Sequence the Tasks

Establish the chronological order of tasks. Determine which tasks are dependent on others and identify any parallel processes. Sequencing tasks is essential for understanding the flow of the procedure.

Step 5: Define Task Goals and Objectives

For each task and sub-task, define the goals and objectives. What should be achieved in each step? For instance, in gallbladder dissection, the goal might be to safely detach the gallbladder from the liver while preserving nearby structures.

Step 6: Skill and Equipment Requirements

Specify the skills and equipment required for each task. Consider the level of expertise needed, such as basic laparoscopic skills or advanced robotic manipulation. Document the instruments and technology involved.

Step 7: Cognitive Processes

Identify the cognitive processes involved, such as decision-making, spatial orientation, and problem-solving. Understanding the mental aspects of surgery is critical for training and error prevention.

Step 8: Consider Variations and Complications

Acknowledge potential variations in the procedure and anticipate complications. How would the surgical team adapt if unexpected issues arise? Task analysis should encompass both the standard procedure and potential deviations.

Step 9: Develop Training and Assessment Tools

Use the task analysis results to create structured training modules. These modules should align with the identified tasks, objectives, and skill requirements. Additionally, design assessment tools to evaluate the competence of trainees and surgical teams.

Step 10: Continuous Improvement

Task analysis is not a one-time endeavor. Regularly revisit the analysis to incorporate new techniques, technology, and best practices. Continuous improvement is vital for staying at the forefront of surgical care.

Implementing Task Analysis Results:

Once task analysis is complete, it's crucial to implement the findings effectively:

1. Training Programs: Develop and deliver training programs based on the task analysis. These programs should encompass both simulation-based training and real-life surgical experience.

2. Skill Assessment: Use the assessment tools developed during task analysis to evaluate the skills of surgical teams. This can be done through structured evaluations and objective metrics.

3. Quality Improvement: Task analysis can reveal areas for process improvement. Work with the surgical team to implement changes that enhance efficiency and patient outcomes.

4. Error Prevention: Utilize the identified points of error to develop strategies for error prevention. This might involve checklists, preoperative briefings, and enhanced communication protocols.

5. Research and Innovation: Task analysis can also guide research efforts, leading to the development of new techniques and technologies that improve surgical procedures.

In conclusion, task analysis is an indispensable tool in understanding, teaching, and advancing complex surgical procedures such as laparoscopic and robotic surgeries. By meticulously dissecting each task and sub-task, identifying skill requirements, and considering cognitive processes, healthcare professionals can enhance patient safety, optimize surgical workflows, and continually improve the quality of surgical care. Task analysis is not merely an analytical exercise; it is a pathway to excellence in surgical practice.

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