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When a Boeing 737 MAX 8 plane crashed just minutes after taking off from Jakarta, the capital of Indonesia, investigators realized that they needed to locate the aircraft's "black box" to understand what had gone wrong. In aviation, black box is a common term used for the flight data recorder, a recording system that is located in the cockpit of an airplane or helicopter. It is designed to record all the actions, movements, and other details that occur during a flight. Although data from the external flight trackers indicated that the plane had erratic speed and altitude early in the flight, the investigators required the black box to correlate the data and determine the cause of the crash.
Teodor Grantcharov, MD, PhD, a staff surgeon at St. Michael's Hospital in Toronto, Canada, and professor of surgery at the University of Toronto, and his team adapted aviation black box technology to create the OR Black Box for use during surgical procedures. Their goal was to provide a tool to help reduce errors and subsequent postoperative complications. Similar to the black box used in aviation, surgeons can review the footage and identify opportunities for improvement.
Although the perioperative model is more complex than the aviation model, the box is approximately the size of a box of facial tissues or a gaming console, and includes a comprehensive multiport data recorder with microphones, cameras, and other sensors. It captures staff member conversations, logs temperature and decibel levels, records the video feed from the surgical camera, and provides a wideangle view of the entire OR. After the procedure, computer algorithms analyze, synchronize, and encrypt the collected data before perioperative experts (ie, surgeons, anesthesia professionals, nurses) review it. Currently, perioperative black box technology is only designed for use during laparoscopic procedures. According to Grantcharov, "It was implemented in 2014 and now is being use[d] in 10 ORs around the world, and there will be six more added within the next few months. We are now at a stage where we can expand."
Although the aviation black boxes were the inspiration for the perioperative device, the purposes for the two devices differ. Safety engineers and investigators use aviation black boxes to determine the cause of a disaster or incident, whereas designers expect...