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Invited Commentary
January 23, 2019

A Video Is Worth a Thousand Operative Notes

Author Affiliations
  • 1Department of Surgery, University of Michigan, Ann Arbor
  • 2Surgical Innovation Editor, JAMA Surgery
  • 3Department of Surgery, Harborview Medical Center, University of Washington, Seattle
JAMA Surg. 2019;154(5):389-390. doi:10.1001/jamasurg.2018.5247

How serious are we about improving surgical quality? If we want to take the next step at improving the quality of our craft, we need to take advantage of the richest source of data available to us: operative video. Most efforts to improve surgical quality focus on optimizing care before surgery (eg, adhering to evidence-based processes around preventing wound infection and deep venous thrombosis) and the early recognition and treatment of complications to mitigate downstream harm (eg, failure to rescue). While these efforts will improve care, we need to push the frontier to improving what happens in the operating room—the quality of the operation itself.

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    1 Comment for this article
    Image documentation of critical operative steps
    Harald Aanning |
    When doing laparoscopic cholecystectomies (and other procedures) we utilized the video camera to capture the critical maneuvers: 1) preoperative view of GB; 2) cystic duct isolation and clipping; 3) cholangiogram image; 4) clipping cystic artery; 5) gallbladder fossa; 6) opened gallbladder (at sidetable). The image sheets were placed in patients' charts, our clinic records, and given to patients/families who were incredibly appreciative...
    CONFLICT OF INTEREST: None Reported
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