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eoScholar: pre-operative warm-up

Pre-operative warm-up / rehearsal.  


There is a growing body of evidence that warming up prior to operating improves subsequent performance. This is perhaps intuitive - all athletes, musicians and other performance-based professionals warm-up or tune-up immediately prior to performing. Below are four recent papers on the topic and their key findings:

Cognitive rehearsal of a task without physical movement (mental warm-up) improves physical task performance:
Randomized clinical trial to evaluate mental practice in enhancing advanced laparoscopic surgical performance. Louridas M, Bonrath EM, Sinclair DA, Dedy NJ, Grantcharov TP. Br J Surg. 2014 Oct 21.

As little as 15 minutes with a simulator can improve both technical skills and cognitive performance, including attention, distraction and spatial reasoning:
Laparoscopic warm-up exercises improve performance of senior-level trainees during laparoscopic renal surgery. Lee JYJ, Mucksavage PP, Kerbl DCD, Osann KEK, Winfield HNH, Kahol KK, et al.  J Endourol. 2012 Apr 30;26(5):545–50.

Only 15.3% of surgeons currently use any form of pre-operative warm-up. 59.5% believe there is a role in daily surgical practice for warm-up and if a validated warm up tool were to be developed 86.1% would use it:
Pre-operative warm up: are we missing an opportunity to improve performance? A questionnaire. Loan JJ, Hughes MA. Int J Surg. 2013;11(5):434. doi: 10.1016/j.ijsu.2013.03.002

Team warm-up / rehearsal may improve team performance and non-technical skills, as well as technical performance in the operator:
Improving clinical performance using rehearsal or warm-up: an advanced literature review of randomized and observational studies. O’Leary JD, O’Sullivan O, Barach P, Shorten GD. Academic Medicine. 2014 Oct;89(10):1416-22. doi: 10.1097/ACM.0000000000000391.


R. Partridge. December 2014.