Dedicated robotics team reduces pre-surgical preparation time

Abstract

Context:Robot-Assisted Laparoscopic Radical Prostatectomy (RALRP) requires significant preoperative setup time for the room, staff, and surgical platform. The utilization of a dedicated robotics operating room (OR) staff may facilitate efficiency and decrease costs.Aims:We sought to determine the degree to which preoperative time decreased as experience was gained.Materials and Methods:A total of 476 patients with a mean age of 60.2 years were evaluated (11/2006 to 1/2010). Data was assimilated through an institutional review board approved blinded, prospective database. Utilizing time from patient arrival in the OR to robot docking as preoperative preparation, our experience was evaluated. Age, body mass index (BMI), and American Society of Anesthesiologists risk scores (ASA) were compared.Statistical Analysis Used:Analysis of variance; Two-sample t-test for unequal variances.Results:The first and last 100 cases were found to have similar age (P=0.27), BMI (P=0.11), and ASA (P=0.09). The average preoperative times were 66. 4 and 53.4 min, respectively (P<0.05). The second 100 patients treated were found to have a significantly shorter preoperative time when compared to the first 100 patients (P<0.05). When the first 100 cases were divided into cohorts of 10 cases the mean preoperative time for the first through fourth cohorts were 80.5, 69.3, 78.8, and 64.7 min, respectively. After treatment of our first 30 patients we found a significant drop in preoperative time. This persisted throughout the remainder of our experience.Conclusions:From the time of patient arrival a number of tasks are accomplished by the non-physician operating room staff during RALRP. The use of a consistent staff can decrease preoperative setup times and, therefore, the overall length of surgery.

Propensity-Matched Analysis of Sigmoidectomies for Diverticular Disease

“…16,17 The utilization of a dedicated RS team has been associated with decreased preoperative setup times, as well as overall length of surgery. 18 Lasser and colleagues 18 demonstrated that operating room staff consistency decreased overall operating room times in 10-case increments through enhanced efficiency prior to the incision. The longer operating times reported in these studies do not appear to be associated with worse outcomes.…”

Robotic-Assisted Transperitoneal Pelvic Lymphadenectomy for Metastatic Melanoma: Early Outcomes Compared with Open Pelvic Lymphadenectomy

“…Utilization of a dedicated operating room team experienced in robotic set-up, as is the practice in our institution, is critical in maintaining equivalent OR room and turnover times [19]. Partnering with surgeons experienced with rPLND for other indications can also help minimize the learning curve.…”

Comparison of short‐term outcomes between robot‐assisted and laparoscopic rectal surgery for rectal cancer: A propensity score‐matched analysis using the Japanese Nationwide diagnosis procedure combination database

“…4,6,7,12 This is possibly because of the inclusion of a docking procedure that is not required for laparoscopic surgery. However, the time from admission to docking is expected to decrease as the team's surgical experience increases, 16 and anesthesia time may thus decrease and become similar to that of laparoscopic surgery as the number of surgeries increases. Furthermore, this study covered the first 2 years since robot-assisted rectal cancer surgery became covered by insurance in Japan, when many facilities introduced robotassisted surgery simultaneously.…”