Learning Objectives:

Introduction: The development of Endoscopic Ear Surgery (EES), from being an adjunct to microscopic dissection to becoming the prime methodology in select cases, has been an exciting recent development. This work assesses the experience of theatre team members with EES versus conventional ear surgery.

Methodology: A questionnaire was designed covering the areas of theatre time management (planning and organisation, leadership and direction, inter-team working), team thinking (shared situational understanding, thinking ahead, decision making) and team safety (safe practice, equipment use, low energy and fatigue), comparing EES to conventional microsurgery of the ear. The scale used was: 1-much worse, 2-somewhat worse, 3-neither better nor worse, 4-somewhat better, 5-much better.

Results: The respondents included 7 theatre nurses, 3 anaesthetists and 3 theatre practitioners. All respondents reported a greater subjective satisfaction with EES mainly with regard to being able to appreciate what was happening during the surgery. The anaesthetists reported that it was easier to anticipate anaesthetic requirements at the close of the procedure in EES and that patients were more comfortable postoperatively. Five out of the seven nurses consistently rated EES as a 4 or 5 compared to conventional ear surgery with regard to theatre team management, team thinking and team safety. EES was initially perceived as challenging by the nurses but with experience they report a greater degree of involvement and satisfaction with the endoscopic procedure. The theatre practitioners rated EES to be better in theatre team management and team thinking but as equivocal with regard to team safety.

Conclusion: Theatre staff report an initial challenging learning curve with EES. With time however the theatre team satisfaction levels are higher due to greater awareness and involvement with the surgical procedure.

Learning points: The theatre team shows high levels of satisfaction with EES.