Live Surgery: A retrospective study on the outcomes and complications of 7 orthopedic live surgery events - 03/06/21

Doi : 10.1016/j.otsr.2021.102871

Laurent Lafosse ^a, Marie Protais ^b,⁎ , M. Christian Moody ^c, Manon Colas ^d, Ken Lee Puah ^e, Thibault Lafosse ^a,^d
^a Alps surgery institute: hand, upper limb, brachial plexus, and microsurgery unit (PBMA), clinique générale d’Annecy, 4, chemin de la Tour la Reine, 74000 Annecy, France
^b Department of orthopedics and traumatology–service of hand and upper limb, Saint Antoine hospital, Assistance Publique–hôpitaux de Paris (AP–HP), 184, rue du faubourg Saint Antoine, 75012, Paris, France
^c Department of Hand, upper extremity and microsurgery, Prisma Health System, Greenville, SC, USA
^d Department of Orthopedics and Traumatology–Service of Hand, Upper Limb and Peripheral Nerve Surgery, Georges-Pompidou European Hospital (HEGP), Assistance Publique–Hôpitaux de Paris (APHP), 20, rue Leblanc, 75015 Paris, France
^e Department of Orthopaedic Surgery, Singapore General Hospital, 20, College Road, Academia, Level 4 169856, Singapore

^*Corresponding author.

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Abstract

Introduction

Live surgery has always been an invaluable part of medical education. Live Surgery Events (LSE) have recently been criticized in France, arguing that unnecessary risks have been placed on the patients.

Hypothesis

We want to report our experience in organizing the last 7 shoulder LSE over the past 12 years focusing on the results and complications during and after the surgeries performed during these courses.

Material and methods

190 patients benefited from live shoulder surgery between 2005 and 2017. 11 of them were lost to follow up, thus 179 patients were included. The mean follow-up was 7,5 years for the instability group, 6,7 years for the rotator cuff group, 7,5 years for the arthroplasty group and 6,8 years for the nerve group. This study is a retrospective analysis of prospectively collected data. We report the epidemiology of the surgeries perfomed and analyzed the patient outcomes: peri and postoperative complications. We evaluated the educational benefit for the attendees of this shoulder LSE through a questionnaire.

Results

There were 6 (3.1%) peri or immediate postoperative complications. There were 33 (18%) long term complications needing 26 (14%) revisions. 90% of the surgeons audience attending the events evaluated the educational benefit from good to very good.

Discussion

Over the years, we have standardized the organization of the meeting to ensure maximum safety, while still respecting patient integrity and anonymity. Our complications rates seem within the ranges found in the current literature for each procedure. Our LSE has been an instrument for education, but also for matching patients with complex problems with experienced surgeons, to the benefit of the patient. Our experience has shown that LSE may induce potential dangers and complications can arise. However, these events should follow rigorous rules and not just recommendations.