Sleep deprivation among surgical residents: does it affect performance while practising a laparoscopic intestinal anastomosis?

Abstract

Introduction: To assess the impact of fatigue due to incorrect night rest in the performance of a laparoscopic manual anastomosis.

Methods: A prospective study evaluating the results from the realization of a manual endotrainer entero-enteral anastomosis performed by residents in terms of fatigue caused by inadequate nightly rest. Two groups were established; the fatigue group (F): anastomosis performed by residents coming off shift who slept less than seven hours and the rest group (R), being those who slept at home for more than 7 hours. The time taken, length of the anastomosis and quality of such were compared based on 4 parameters: Air leak test, correct tension on the suture line, accurate opposition of the edges and optimal distance between stitches.

Results: 402 anastomoses were studied (211 rest group, 191 fatigue group). In the fatigue group leaks were detected in 33,5% anastomoses, as opposed to 19,4% in the rest group (p < 0.01). El rest group performed the anastomosis in 56,75 min and the fatigue group in 61,49 min (p = 0.006). There were no significant differences in the others parameters.

Conclusions: Fatigue increases the risk of leakage and the time to do the exercise.

Keywords: Deprivación de sueño; Entrenamiento en habilidades quirúrgicas laparoscópicas; Entrenamiento residente; Fatiga; Fatigue; Laparoscopic surgical skills training; Resident training; Sleep deprivation.