Du compte rendu opératoire à la résilience chirurgicale : l’histoire d’une chaire, le défi d’une Académie

The operative report remains the primary source describing intraoperative events, yet it is limited by omission bias and a predominantly technical perspective of surgical activity. However, surgical performance emerges from a complex and dynamic process involving human, technical, organizational, and environmental factors. Through a literature review on the surgical black box and the BOPA approach, based on 284 hours of video analysis with second-by-second annotation of hepatectomies, this work aims to better characterize intraoperative dynamics. The objective is to identify critical sequences, from triggering factors to the genesis of human errors and intraoperative adverse events. This systemic approach seeks to move beyond individual technical competence toward the promotion of resilient surgical teams and systems, as a key determinant of surgical safety and quality.