My Surgery Preparation Ritual

My preparation for surgery is a ritual. 

I would like to share with you my 4 step surgical preparation process.

Pre surgical planning and visualisation of the case

This starts from the very first encounter with the patient. The clinical and relevant special investigations are processed carefully to determine an appropriate treatment plan. The information collated leads to clarity. Very much like the image of a puzzle coming together as you fit the many pieces together. The planning involves writing down the steps of surgery and then reading through the prescription multiple times. For bigger cases I like to print a 3D model of the surgical site so I can complete practice surgeries. Like Beth Harmon from the Queens Gambit (Netflix series which I highly recommend) imagines a chess board on the ceiling, I like to imagine the surgical procedure playing out in front of me.

Pre surgical team briefing

This is a relatively new step in my practice following listening to Frank Renouard (Dental Implant Surgeon) and recalling my experience as a doctor working in surgery. The briefing acts as a communication and teamwork tool that supports the sharing of information and early identification of potential issues. A simple verbal exchange at the start of the day can build teamwork, improve communication and reduce errors. Patient safety is improved when teams communicate well and work well together.

Getting in the flow and laser focusing on the planned surgery

This is a mental state of operation which involves being full immersed in a feeling of excitement, deep involvement and joy in the process of the activity. When in the zone you are completely absorbed in the task at hand.

Take a minute to clear your mind

Avoid interruptions by taking steps to ensure you are not interrupted at all when you get in the zone.

Ready you brain by being well hydrated, nourished with a healthy snack and non distracting background music.

And finally the adoption of the sterile cockpit principle.

The sterile cockpit principle is a federal aviation administration (FAA) regulation which states that during critical phases of flight only activities required for the safe operation of the aircraft may be actioned, and all non-essential activities in the cockpit are forbidden. The principle was brought into force in 1981 after the review of a number of accidents that were caused by flight crews who were distracted from their flying duties by engaging in non-essential conversations and activities during critical parts of the flight. It is an inescapable fact that humans are susceptible to human error. The aviation industry recognised the role of human error in accidents and adopted training programmes to combat this which proved to be highly effective. The sterile cockpit principle forms part of human factors training which is now an essential training programme for personal involved in the aviation industry.

Adopting the sterile cockpit principle in the dental surgery involves avoiding non-essential conversations and interruptions from outside the surgery. For this to work effectively it is crucial all team members are educated on the principles and the rationale behind its employment.

These ritual steps assist me to achieve a state of flow so I can complete my surgeries successfully and reduce the risk of human error.