To the discussion of the problem of errors in neurosurgery. Literature review

Abstract

Among all adverse perioperative events, medical error is one of the most serious, associated with possible complications for the patient, severe psychological trauma for the surgeon, and often with the involvement of the Investigative Committee in assessing the results of treatment. At the same time, among the researchers of this issue there is still no consensus on what exactly is meant by «medical error». In modern legal scientific publications, they often call for abandoning this term and using the concept of «negligence» for lawyers. It is all the more important in the professional community to define the concept of «medical error» and distinguish it from other undesirable events associated with the treatment of the patient. This review presents different approaches to the definition of the concepts of «medical error» and «surgical error», what is their main difference from iatrogenic, medical negligence, complications of surgery. Some classifications of errors in surgery are presented. The most common factors of surgical errors are identified, such as lack of competence and experience of the doctor, impaired interaction and communication of staff, excessive workload and fatigue, emergency operations, unusual patient anatomy, lack of necessary equipment and instruments. Using the example of neurosurgical practice, such errors as performing a craniotomy on the wrong side, surgery on the spine at the wrong level, leaving foreign bodies in the wound, and others are considered. In conclusion, the main measures for the prevention of errors in surgery in general and in neurosurgery in particular are described.