Flow disruptions in robotic-assisted abdominal sacrocolpopexy: does robotic surgery introduce unforeseen challenges for gynecologic surgeons?

Souders, Colby P.; Catchpole, Ken; Hannemann, Alex; Lyon, Ronit; Eilber, Karyn S.; Bresee, Catherine; Cohen, Tara N.; Weigl, Matthias; Anger, Jennifer T.

doi:10.1007/s00192-019-03929-6

Cited by 15 publications

(23 citation statements)

References 14 publications

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“…This step can be achieved in 7 min on average. Unlike many other studies, docking time did not include port placement as this step is just as well performed in conventional laparoscopy and should not be considered as extra time [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

From Da Vinci Si to Da Vinci Xi: realistic times in draping and docking the robot

et al. 2020

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Robot-assisted surgery is assumed to be time consuming partially due to extra time needed in preparing the robot. The objective of this study was to give realistic times in Da Vinci Xi draping and docking and to analyse the learning curve in the transition from the Si to the Xi in an experienced team. This prospective study was held in a hospital with a high volume of robot-assisted surgery in general surgery, urology and gynaecology. Times from the moment patients entered the operating room until the surgeon took place behind console were precisely recorded during the first 6 weeks after the implementation of the Xi. In total, 65 procedures were performed and documented. The learning curve for the process of draping and docking the robot was reached after 21 and 18 cases, respectively. Mean times after completion of the learning curve were 5 min for draping and 7 min for docking and were statistically different from mean times before completion of the learning curve (p values < 0.01). In dedicated teams netto extra time needed for preparing the Xi can even be reduced to just the time needed for docking. Thus, setting up the robot should have limited impact on overall time spent in the operation room.

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Section: Discussionmentioning

confidence: 99%

From Da Vinci Si to Da Vinci Xi: realistic times in draping and docking the robot

et al. 2020

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“…Across observational studies, the number of robotic procedures ranged from 1 to 89 procedures. Fourteen studies (Ahmad et al, 2016;Almeras & Almeras, 2019;Cao & Taylor, 2004;Catchpole et al, 2018;Lai & Entin, 2005;Randell et al, 2015;Schiff et al, 2016;Sexton et al, 2018;Tiferes et al, 2019;Tiferes et al, 2016;Weber et al, 2018;Weigl et al, 2018) described the impact of robotic technologies on communication and teamwork performance in surgery, while 11 studies (Ahmad et al, 2016;Catchpole et al, 2016;Dru et al, 2017;Jain et al, 2016;Müller-Stich et al, 2007;Schiff et al, 2016;Sexton et al, 2018;Sorensen et al, 2010;Souders et al, 2019;Weber et al, 2018;Weigl et al, 2018) also described clinical efficiencies relative to set up and operative times, and workflow processes. Only three studies involved more than one type of surgery (Catchpole et al, 2018;Catchpole et al, 2016;Jain et al, 2016).…”

Section: Resultsmentioning

confidence: 99%

“…Thus, team members had to learn how their tasks related to those of others, and how this relatedness affects overall team performance and efficiency (Almeras & Almeras, 2019;Cao & Taylor, 2004;Catchpole et al, 2016;Lai & Entin, 2005). Instrument changes, equipment-related problems and ambulatory movements over the four phases varied, reflected different procedural tasks undertaken over the course of the surgery (Ahmad et al, 2016;Allers et al, 2016;Catchpole et al, 2018;Catchpole et al, 2016;Dru et al, 2017;Souders et al, 2019;Weber et al, 2018;Weigl et al, 2018).…”

Section: Managing the Robotic System To Optimise Workflow Efficiencymentioning

confidence: 99%

The Impact of Robotic-Assisted Surgery on Team Performance: A Systematic Mixed Studies Review

Gillespie

Boorman

et al. 2020

Hum Factors

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Objective The aim of this study is to describe the impact of robotic-assisted surgery on team performance in the operating room. Background The introduction of surgical robots has improved the technical performance of surgical procedures but has also contributed to unexpected interactions in surgical teams, leading to new types of errors. Method A systematic literature search of Cumulative Index to Nursing and Allied Health Literature, PubMed, ProQuest, Cochrane, Web of Science, PsycINFO, and Scopus databases using key words and MeSH terms was conducted. Screening identified studies employing qualitative and quantitative methods published between January 2000 and September 2019. Two reviewers independently appraised the methodological quality of the articles using the Mixed Methods Appraisal Tool (2018). Discussions were held among authors to examine quality scores of the studies and emergent themes, and agreement was reached through consensus. Themes were derived using inductive content analysis. Results Combined searches identified 1,065 citations. Of these, 19 articles, 16 quantitative and 3 qualitative, were included. Robotic-assisted surgeries included urology, gynecology, cardiac, and general procedures involving surgeons, anesthetists, nurses, and technicians. Three themes emerged : Negotiating the altered physical environs and adapting team communications to manage task and technology; managing the robotic system to optimize workflow efficiency; and technical proficiency depends on experience, team familiarity, and case complexity. Conclusion Inclusion of a robot as a team member adds further complexity to the work of surgery. Application These review findings will inform training programs specifically designed to optimize teamwork, workflow efficiency, and learning needs.

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“…TeamSTEPPS, an evidence-based framework for improving quality care and patient outcomes, emphasizes the importance of cultivating team attitudes, to increase knowledge, performance, and skills [ 22 ]. Souders et al [ 23 ] reviewed 24 robotic Sacrocolpopexy cases and identified how any human factor can impact or disrupt surgical flow. Docking and port placement, roles typically assumed by the RBA, accounted for the highest rate of disruptions to surgical flow, (19.2 ± 14.4 flow disruptions per hour), [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Implementation of a standardized robotic assistant surgical training curriculum

et al. 2021

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Since 2000, robotic-assisted surgery has rapidly expanded into almost every surgical sub-specialty. Despite the popularity of robotic surgery across the United States, a national consensus for standardized training and education of robotic surgeons or surgical teams remains absent. In this quality improvement initiative, a novel, stepwise iterative Robotic Assistant Surgical Training (RAST) curriculum was developed to broaden and standardize robotic bedside assistant training. Thirteen voluntary participants, capable of fulfilling the bedside assistant role, were evaluated to determine if RAST enhanced the learner’s self-perceived level of confidence and comfort in their role as bedside assistant. A pre- and post-RAST training survey and a between-stages repeated-measures survey were conducted. All learner participants reported statistically significant increases in confidence and comfort after RAST training, ( p = < 0.001), and between each stage, F (2, 24 = 60.47, p < .001; = 0.834). Participant feedback regarding curriculum improvement was obtained, suggesting the desire for more training and practice, in smaller groups of 2–3 participants. One hundred percent of participants felt RAST was beneficial and that it should be implemented as standardized training during onboarding for all robotic bedside assistants. Thus, a standardized, stepwise iterative robotic bedside assistant curriculum increases learner preparedness, comfort, and confidence, safely away from the patient bedside. Supplementary Information The online version contains supplementary material available at 10.1007/s11701-021-01291-8.

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Flow disruptions in robotic-assisted abdominal sacrocolpopexy: does robotic surgery introduce unforeseen challenges for gynecologic surgeons?

Cited by 15 publications

References 14 publications

From Da Vinci Si to Da Vinci Xi: realistic times in draping and docking the robot

From Da Vinci Si to Da Vinci Xi: realistic times in draping and docking the robot

The Impact of Robotic-Assisted Surgery on Team Performance: A Systematic Mixed Studies Review

Implementation of a standardized robotic assistant surgical training curriculum

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