Skip to main content
Top
Published in: Surgical Endoscopy 6/2018

01-06-2018 | SAGES FUSE PROGRAM

The SAGES Fundamental Use of Surgical Energy program (FUSE): history, development, and purpose

Authors: P. Fuchshuber, S. Schwaitzberg, D. Jones, S. B. Jones, L. Feldman, M. Munro, T. Robinson, G. Purcell-Jackson, D. Mikami, A. Madani, M. Brunt, B. Dunkin, C. Gugliemi, L. Groah, R. Lim, J. Mischna, C. R. Voyles

Published in: Surgical Endoscopy | Issue 6/2018

Login to get access

Abstract

Background

Adverse events due to energy device use in surgical operating rooms are a daily occurrence. These occur at a rate of approximately 1–2 per 1000 operations. Hundreds of operating room fires occur each year in the United States, some causing severe injury and even mortality. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) therefore created the first comprehensive educational curriculum on the safe use of surgical energy devices, called Fundamental Use of Surgical Energy (FUSE). This paper describes the history, development, and purpose of this important training program for all members of the operating room team.

Methods

The databases of SAGES and the FUSE committee as well as personal photographs and documents of members of the FUSE task force were used to establish a brief history of the FUSE program from its inception to its current status.

Results

The authors were able to detail all aspects of the history, development, and national as well as global implementation of the third SAGES Fundamentals Program FUSE.

Conclusions

The written documentation of the making of FUSE is an important contribution to the history and mission of SAGES and allows the reader to understand the idea, concept, realization, and implementation of the only free online educational tool for physicians on energy devices available today. FUSE is the culmination of the SAGES efforts to recognize gaps in patient safety and develop state-of-the-art educational programs to address those gaps. It is the goal of the FUSE task force to ensure that general FUSE implementation becomes multinational, involving as many countries as possible.
Literature
1.
go back to reference Sankaranarayanan G, Resapu RR, Jones DB, Schwaitzberg S, De S (2013) Common uses and cited complications of energy in surgery. Surg Endosc 27(9):3056–3072CrossRefPubMedPubMedCentral Sankaranarayanan G, Resapu RR, Jones DB, Schwaitzberg S, De S (2013) Common uses and cited complications of energy in surgery. Surg Endosc 27(9):3056–3072CrossRefPubMedPubMedCentral
2.
go back to reference Schwaitzberg SD (2012) Evolution and revolutions in surgical energy. In: Feldman LS, Fuchshuber P, Jones DB (eds) The Fundamental Use of Surgical Energy (FUSE) manual. Springer, New York, p 3CrossRef Schwaitzberg SD (2012) Evolution and revolutions in surgical energy. In: Feldman LS, Fuchshuber P, Jones DB (eds) The Fundamental Use of Surgical Energy (FUSE) manual. Springer, New York, p 3CrossRef
3.
go back to reference Feldman LS, Brunt LM, Fuchshuber P et al (2013) Rationale for the fundamental use of surgical Energy (FUSE) curriculum assessment: focus on safety. Surg Endosc 27(11):4054–4059CrossRefPubMed Feldman LS, Brunt LM, Fuchshuber P et al (2013) Rationale for the fundamental use of surgical Energy (FUSE) curriculum assessment: focus on safety. Surg Endosc 27(11):4054–4059CrossRefPubMed
4.
go back to reference Feldman LS, Fuchshuber P, Jones DB, Mischna J, Schwaitzberg SD (2012) FUSE (Fundamental Use of Surgical Energy) Task Force. Surgeons don’t know what they don’t know about the safe use of energy in surgery. Surg Endosc 26(10):2735–2739CrossRefPubMed Feldman LS, Fuchshuber P, Jones DB, Mischna J, Schwaitzberg SD (2012) FUSE (Fundamental Use of Surgical Energy) Task Force. Surgeons don’t know what they don’t know about the safe use of energy in surgery. Surg Endosc 26(10):2735–2739CrossRefPubMed
5.
go back to reference Fuchshuber PR, Robinson TN, Feldman LS, Jones DB, Schwaitzberg SD (2014 Sep) The SAGES FUSE program: bridging a patient safety gap. Bull Am Coll Surg 99(9):18–27PubMed Fuchshuber PR, Robinson TN, Feldman LS, Jones DB, Schwaitzberg SD (2014 Sep) The SAGES FUSE program: bridging a patient safety gap. Bull Am Coll Surg 99(9):18–27PubMed
6.
go back to reference Fuchshuber P, Jones S, Jones D, Feldman LS, Schwaitzberg S, Rozner MA (2013) Ensuring safety in the operating room: the “fundamental use of surgical energy” (FUSE) program. Int Anesthesiol Clin 51(4):65–80CrossRefPubMedPubMedCentral Fuchshuber P, Jones S, Jones D, Feldman LS, Schwaitzberg S, Rozner MA (2013) Ensuring safety in the operating room: the “fundamental use of surgical energy” (FUSE) program. Int Anesthesiol Clin 51(4):65–80CrossRefPubMedPubMedCentral
7.
go back to reference Feldman LS, Fuchshuber P, Jones DB (eds) (2012) The Fundamental Use of Surgical Energy (FUSE) manual. Springer, New York Feldman LS, Fuchshuber P, Jones DB (eds) (2012) The Fundamental Use of Surgical Energy (FUSE) manual. Springer, New York
8.
go back to reference Madani A, Jones DB, Fuchshuber P, Robinson TN, Feldman LS (2014) Fundamental Use of Surgical Energy™ (FUSE): a curriculum on surgical energy-based devices. Surg Endosc 28(9):2509–2512CrossRefPubMed Madani A, Jones DB, Fuchshuber P, Robinson TN, Feldman LS (2014) Fundamental Use of Surgical Energy™ (FUSE): a curriculum on surgical energy-based devices. Surg Endosc 28(9):2509–2512CrossRefPubMed
9.
go back to reference Robinson TN, Olasky J, Young P, Feldman LS, Fuchshuber PR, Jones SB, Madani A, Brunt M, Mikami D, Jackson GP, Mischna J, Schwaitzberg S, Jones DB (2016 Mar) Fundamental Use of Surgical Energy (FUSE) certification: validation and predictors of success. Surg Endosc 30(3):916–924CrossRefPubMed Robinson TN, Olasky J, Young P, Feldman LS, Fuchshuber PR, Jones SB, Madani A, Brunt M, Mikami D, Jackson GP, Mischna J, Schwaitzberg S, Jones DB (2016 Mar) Fundamental Use of Surgical Energy (FUSE) certification: validation and predictors of success. Surg Endosc 30(3):916–924CrossRefPubMed
10.
go back to reference Madani A, Watanabe Y, Vassiliou MC et al (2014) Impact of a hands-on component on learning in the Fundamental Use of Surgical Energy (FUSE) curriculum: a randomized-controlled trial in surgical trainees. Surg Endosc 28:2772–2782CrossRefPubMed Madani A, Watanabe Y, Vassiliou MC et al (2014) Impact of a hands-on component on learning in the Fundamental Use of Surgical Energy (FUSE) curriculum: a randomized-controlled trial in surgical trainees. Surg Endosc 28:2772–2782CrossRefPubMed
11.
go back to reference Madani A, Watanabe Y, Townsend N, Pucher PH, Robinson TN, Egerszegi PE, Olasky J, Bachman SL, Park CW, Amin N, Tang DT, Haase E, Bardana D, Jones DB, Vassiliou M, Fried GM, Feldman LS (2016 Feb) Structured simulation improves learning of the Fundamental Use of Surgical Energy™ curriculum: a multicenter randomized controlled trial. Surg Endosc 30(2):684–691CrossRefPubMed Madani A, Watanabe Y, Townsend N, Pucher PH, Robinson TN, Egerszegi PE, Olasky J, Bachman SL, Park CW, Amin N, Tang DT, Haase E, Bardana D, Jones DB, Vassiliou M, Fried GM, Feldman LS (2016 Feb) Structured simulation improves learning of the Fundamental Use of Surgical Energy™ curriculum: a multicenter randomized controlled trial. Surg Endosc 30(2):684–691CrossRefPubMed
12.
go back to reference Madani A, Watanabe Y, Vassiliou MC, Fuchshuber P, Jones DB, Schwaitzberg SD, Fried GM, Feldman LS (2016) Long-term knowledge retention following simulation-based training for electrosurgical safety: 1-year follow-up of a randomized controlled trial. Surg Endosc 30(3):1156–1163CrossRefPubMed Madani A, Watanabe Y, Vassiliou MC, Fuchshuber P, Jones DB, Schwaitzberg SD, Fried GM, Feldman LS (2016) Long-term knowledge retention following simulation-based training for electrosurgical safety: 1-year follow-up of a randomized controlled trial. Surg Endosc 30(3):1156–1163CrossRefPubMed
13.
go back to reference Allen BF, Schwaitzberg SD, Jones DB, De S (2014) Toward the development of a virtual electrosurgery training simulator. Stud Health Technol Inform 196:11–13PubMed Allen BF, Schwaitzberg SD, Jones DB, De S (2014) Toward the development of a virtual electrosurgery training simulator. Stud Health Technol Inform 196:11–13PubMed
14.
go back to reference Dorozhkin D, Olasky J, Jones DB, Schwaitzberg SD, Jones SB, Cao CG, Molina M, Henriques S, Wang J, Flinn J, De S, SAGES FUSE Committee (2016) OR fire virtual training simulator: design and face validity. Surg Endosc 31:3527–3533CrossRefPubMed Dorozhkin D, Olasky J, Jones DB, Schwaitzberg SD, Jones SB, Cao CG, Molina M, Henriques S, Wang J, Flinn J, De S, SAGES FUSE Committee (2016) OR fire virtual training simulator: design and face validity. Surg Endosc 31:3527–3533CrossRefPubMed
15.
go back to reference Sankaranarayanan G, Li B, Miller A, Wakily H, Jones SB, Schwaitzberg S, Jones DB, De S, Olasky J (2016) Face validation of the Virtual Electrosurgery Skill Trainer (VEST©). Surg Endosc 30(2):730–738CrossRefPubMed Sankaranarayanan G, Li B, Miller A, Wakily H, Jones SB, Schwaitzberg S, Jones DB, De S, Olasky J (2016) Face validation of the Virtual Electrosurgery Skill Trainer (VEST©). Surg Endosc 30(2):730–738CrossRefPubMed
16.
go back to reference Allen BF, Jones DB, Schwaitzberg SD, Suvranu D (2014 Apr) Survey-based analysis of fundamental tasks for effective use of electrosurgical instruments. Surg Endosc 28(4):1166–1172CrossRefPubMed Allen BF, Jones DB, Schwaitzberg SD, Suvranu D (2014 Apr) Survey-based analysis of fundamental tasks for effective use of electrosurgical instruments. Surg Endosc 28(4):1166–1172CrossRefPubMed
17.
go back to reference Townsend NT, Jones EL, Overbey D, Dunne B, McHenry J, Robinson TN (2017) Single-incision laparoscopic surgery increases the risk of unintentional thermal injury from the monopolar “Bovie” instrument in comparison with traditional laparoscopy. Surg Endosc 31:3146–3151CrossRefPubMed Townsend NT, Jones EL, Overbey D, Dunne B, McHenry J, Robinson TN (2017) Single-incision laparoscopic surgery increases the risk of unintentional thermal injury from the monopolar “Bovie” instrument in comparison with traditional laparoscopy. Surg Endosc 31:3146–3151CrossRefPubMed
19.
go back to reference Townsend NT, Nadlonek NA, Jones EL, McHenry JR, Dunne B, Stiegmann GV, Robinson TN (2016) Unintended stray energy from monopolar instruments: beware the dispersive electrode cord. Surg Endosc 30:1333–1336CrossRefPubMed Townsend NT, Nadlonek NA, Jones EL, McHenry JR, Dunne B, Stiegmann GV, Robinson TN (2016) Unintended stray energy from monopolar instruments: beware the dispersive electrode cord. Surg Endosc 30:1333–1336CrossRefPubMed
20.
go back to reference Townsend NT, Jones EL, Paniccia A, Vandervelde J, McHenry JR, Robinson TN (2015) Antenna coupling explains unintended thermal injury caused by common operating room monitoring devices. Surg Laparosc Endosc Percutan Tech 25:111–113CrossRefPubMed Townsend NT, Jones EL, Paniccia A, Vandervelde J, McHenry JR, Robinson TN (2015) Antenna coupling explains unintended thermal injury caused by common operating room monitoring devices. Surg Laparosc Endosc Percutan Tech 25:111–113CrossRefPubMed
21.
go back to reference Robinson TN, Jones EL, Dunn CL, Dunne B, Johnson E, Townsend NT, Paniccia A, Stiegmann GV (2015) Separating the laparoscopic camera cord from the monopolar “Bovie” cord reduces unintended thermal injury from antenna coupling: a randomized controlled trial. Ann Surg 261:1056–1060CrossRefPubMed Robinson TN, Jones EL, Dunn CL, Dunne B, Johnson E, Townsend NT, Paniccia A, Stiegmann GV (2015) Separating the laparoscopic camera cord from the monopolar “Bovie” cord reduces unintended thermal injury from antenna coupling: a randomized controlled trial. Ann Surg 261:1056–1060CrossRefPubMed
22.
go back to reference Robinson TN, Varosy PD, Guillaume G, Dunning JE, Townsend NT, Jones EL, Paniccia A, Stiegmann GV, Weyer C, Rozner MA (2014) Effect of radiofrequency energy emitted from monopolar “Bovie” instruments on cardiac implantable electronic devices. J Am Coll Surg 219:399–406CrossRefPubMed Robinson TN, Varosy PD, Guillaume G, Dunning JE, Townsend NT, Jones EL, Paniccia A, Stiegmann GV, Weyer C, Rozner MA (2014) Effect of radiofrequency energy emitted from monopolar “Bovie” instruments on cardiac implantable electronic devices. J Am Coll Surg 219:399–406CrossRefPubMed
23.
go back to reference Paniccia A, Rozner M, Jones EL, Townsend NT, Varosy PD, Dunning JE, Girard G, Weyer C, Stiegmann GV, Robinson TN (2014) Electromagnetic interference caused by common surgical energy-based devices on an implanted cardiac defibrillator. Am J Surg 208:932–936 (discussion 935–6)CrossRefPubMed Paniccia A, Rozner M, Jones EL, Townsend NT, Varosy PD, Dunning JE, Girard G, Weyer C, Stiegmann GV, Robinson TN (2014) Electromagnetic interference caused by common surgical energy-based devices on an implanted cardiac defibrillator. Am J Surg 208:932–936 (discussion 935–6)CrossRefPubMed
24.
go back to reference Jones EL, Dunn CL, Townsend NT, Jones TS, Bruce Dunne J, Montero PN, Govekar HR, Stiegmann GV, Robinson TN (2013) Blend mode reduces unintended thermal injury by laparoscopic monopolar instruments: a randomized controlled trial. Surg Endosc 27:4016–4020CrossRefPubMed Jones EL, Dunn CL, Townsend NT, Jones TS, Bruce Dunne J, Montero PN, Govekar HR, Stiegmann GV, Robinson TN (2013) Blend mode reduces unintended thermal injury by laparoscopic monopolar instruments: a randomized controlled trial. Surg Endosc 27:4016–4020CrossRefPubMed
25.
go back to reference Govekar HR, Robinson TN, Varosy PD, Girard G, Montero PN, Dunn CL, Jones EL, Stiegmann GV (2012) Effect of monopolar radiofrequency energy on pacemaker function. Surg Endosc 26:2784–2788CrossRefPubMed Govekar HR, Robinson TN, Varosy PD, Girard G, Montero PN, Dunn CL, Jones EL, Stiegmann GV (2012) Effect of monopolar radiofrequency energy on pacemaker function. Surg Endosc 26:2784–2788CrossRefPubMed
26.
go back to reference Jones EL, Robinson TN, McHenry JR, Dunn CL, Montero PN, Govekar HR, Stiegmann GV (2012) Radiofrequency energy antenna coupling to common laparoscopic instruments: practical implications. Surg Endosc 26:3053–3057CrossRefPubMed Jones EL, Robinson TN, McHenry JR, Dunn CL, Montero PN, Govekar HR, Stiegmann GV (2012) Radiofrequency energy antenna coupling to common laparoscopic instruments: practical implications. Surg Endosc 26:3053–3057CrossRefPubMed
27.
go back to reference Robinson TN, Barnes KS, Govekar HR, Stiegmann GV, Dunn CL, McGreevy FT (2012) Antenna coupling–a novel mechanism of radiofrequency electrosurgery complication: practical implications. Ann Surg 256:213–218CrossRefPubMed Robinson TN, Barnes KS, Govekar HR, Stiegmann GV, Dunn CL, McGreevy FT (2012) Antenna coupling–a novel mechanism of radiofrequency electrosurgery complication: practical implications. Ann Surg 256:213–218CrossRefPubMed
28.
go back to reference Montero PN, Robinson TN, Weaver JS, Stiegmann GV (2010) Insulation failure in laparoscopic instruments. Surg Endosc 24:462–465CrossRefPubMed Montero PN, Robinson TN, Weaver JS, Stiegmann GV (2010) Insulation failure in laparoscopic instruments. Surg Endosc 24:462–465CrossRefPubMed
29.
go back to reference Robinson TN, Pavlovsky KR, Looney H, Stiegmann GV, McGreevy FT (2010) Surgeon-controlled factors that reduce monopolar electrosurgery capacitive coupling during laparoscopy. Surg Laparosc Endosc Percutan Tech 20:317–320CrossRefPubMed Robinson TN, Pavlovsky KR, Looney H, Stiegmann GV, McGreevy FT (2010) Surgeon-controlled factors that reduce monopolar electrosurgery capacitive coupling during laparoscopy. Surg Laparosc Endosc Percutan Tech 20:317–320CrossRefPubMed
30.
go back to reference Jones EL, Overbey DM, Chapman BC, Jones TS, Hilton SA, Moore JT, Robinson TN (2017) Operating room fires and surgical skin preparation. J Am Coll Surg 225(1):160–165CrossRefPubMed Jones EL, Overbey DM, Chapman BC, Jones TS, Hilton SA, Moore JT, Robinson TN (2017) Operating room fires and surgical skin preparation. J Am Coll Surg 225(1):160–165CrossRefPubMed
31.
go back to reference Jones EL, Dunn CL, Townsend NT, Jones TS, Bruce Dunne J, Montero PN, Govekar HR, Stiegmann GV, Robinson TN (2013) Blend mode reduces unintended thermal injury by laparoscopic monopolar instruments: a randomized controlled trial. Surg Endosc 27(11):4016–4020CrossRefPubMed Jones EL, Dunn CL, Townsend NT, Jones TS, Bruce Dunne J, Montero PN, Govekar HR, Stiegmann GV, Robinson TN (2013) Blend mode reduces unintended thermal injury by laparoscopic monopolar instruments: a randomized controlled trial. Surg Endosc 27(11):4016–4020CrossRefPubMed
32.
go back to reference Govekar HR, Robinson TN, Stiegmann GV, McGreevy FT (2011) Residual heat of laparoscopic energy devices: how long must the surgeon wait to touch additional tissue? Surg Endosc 25(11):3499–3502CrossRefPubMed Govekar HR, Robinson TN, Stiegmann GV, McGreevy FT (2011) Residual heat of laparoscopic energy devices: how long must the surgeon wait to touch additional tissue? Surg Endosc 25(11):3499–3502CrossRefPubMed
33.
go back to reference Robinson TN, Pavlovsky KR, Looney H, Stiegmann GV, McGreevy FT (2010) Surgeon-controlled factors that reduce monopolar electrosurgery capacitive coupling during laparoscopy. Surg Laparosc Endosc Percutan Tech 20(5):317–320CrossRefPubMed Robinson TN, Pavlovsky KR, Looney H, Stiegmann GV, McGreevy FT (2010) Surgeon-controlled factors that reduce monopolar electrosurgery capacitive coupling during laparoscopy. Surg Laparosc Endosc Percutan Tech 20(5):317–320CrossRefPubMed
34.
go back to reference Ulmer BC (2016) What is your energy IQ? FUSE: bridging a patient safety gap. AORN J 103(3):333–337CrossRefPubMed Ulmer BC (2016) What is your energy IQ? FUSE: bridging a patient safety gap. AORN J 103(3):333–337CrossRefPubMed
35.
go back to reference Jones DB, Brunt LM, Feldman LS, Mikami DJ, Robinson TN (2015) Jones SB Safe energy use in the operating room. Curr Probl Surg 52(11):447–468CrossRefPubMed Jones DB, Brunt LM, Feldman LS, Mikami DJ, Robinson TN (2015) Jones SB Safe energy use in the operating room. Curr Probl Surg 52(11):447–468CrossRefPubMed
36.
go back to reference Jones SB, Munro MG, Feldman LS, Robinson TN, Brunt LM, Schwaitzberg SD, Jones DB, Fuchshuber PR (2017) Fundamental Use of Surgical Energy (FUSE): an essential educational program for operating room safety. Perm J 21:34–45 Jones SB, Munro MG, Feldman LS, Robinson TN, Brunt LM, Schwaitzberg SD, Jones DB, Fuchshuber PR (2017) Fundamental Use of Surgical Energy (FUSE): an essential educational program for operating room safety. Perm J 21:34–45
37.
go back to reference Fuchshuber PR, Robinson TN, Feldman LS, Brunt LM, Madani A, Jones SB, Rozner MA, Munro MG, Mishna J, Schwaitzberg SD, Jones DB (2015) Fundamental Use of Surgical Energy (FUSE): closing a gap in medical education. Ann Surg 262(1):20–22CrossRefPubMedPubMedCentral Fuchshuber PR, Robinson TN, Feldman LS, Brunt LM, Madani A, Jones SB, Rozner MA, Munro MG, Mishna J, Schwaitzberg SD, Jones DB (2015) Fundamental Use of Surgical Energy (FUSE): closing a gap in medical education. Ann Surg 262(1):20–22CrossRefPubMedPubMedCentral
38.
go back to reference Fuchshuber P (2017) Das SAGES FUSE, Programm: Ein Ansatz zur Vermeidung von Komplikationen im OP. Chirurgen Magazin 84:46–49 Fuchshuber P (2017) Das SAGES FUSE, Programm: Ein Ansatz zur Vermeidung von Komplikationen im OP. Chirurgen Magazin 84:46–49
39.
go back to reference Fuchshuber PR, Schwaitzberg SD, Rabrenovich V, Feldman LS, Jones DB (2014) Brief update on surgical safety and outcomes: NSQIP and FUSE. E-memoirs Natl Acad Surg 13(4):064–069 Fuchshuber PR, Schwaitzberg SD, Rabrenovich V, Feldman LS, Jones DB (2014) Brief update on surgical safety and outcomes: NSQIP and FUSE. E-memoirs Natl Acad Surg 13(4):064–069
40.
go back to reference Voyles CR, Tucker RD (1992) Education and engineering solutions for potential problems with laparoscopic monopolar electrosurgery. Am J Surg 164(1):57–62CrossRefPubMed Voyles CR, Tucker RD (1992) Education and engineering solutions for potential problems with laparoscopic monopolar electrosurgery. Am J Surg 164(1):57–62CrossRefPubMed
41.
go back to reference Tucker RD, Voyles CR (1995) Laparoscopic electrosurgical complications and their prevention. AORN J 62(1):51–59CrossRefPubMed Tucker RD, Voyles CR (1995) Laparoscopic electrosurgical complications and their prevention. AORN J 62(1):51–59CrossRefPubMed
43.
Metadata
Title
The SAGES Fundamental Use of Surgical Energy program (FUSE): history, development, and purpose
Authors
P. Fuchshuber
S. Schwaitzberg
D. Jones
S. B. Jones
L. Feldman
M. Munro
T. Robinson
G. Purcell-Jackson
D. Mikami
A. Madani
M. Brunt
B. Dunkin
C. Gugliemi
L. Groah
R. Lim
J. Mischna
C. R. Voyles
Publication date
01-06-2018
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 6/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-017-5933-y

Other articles of this Issue 6/2018

Surgical Endoscopy 6/2018 Go to the issue