Optimizing the robotic surgery team: an operations management perspective

Harmanli, Oz; Solak, Senay; Bayram, Armagan; Yüksel, Beril; Jones, Keisha

doi:10.1007/s00192-020-04527-7

Cited by 6 publications

(8 citation statements)

References 20 publications

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“…Similarly, our results suggest that like previous reports, DART improved operative efficiency; when using room turnaround time (TAT) as a surrogate, TATs were decreased by over 20 min for every case in the last year of the study period compared to the pre‐DART period (58.6 pre‐DART vs. 40 min post DART and 36 min in 2022; p < .001). Other studies have shown increased efficiency with a specialized team via decreased operating times, a phenomenon that has been called “the assistant effect” 9,10 . Although this association was of interest in this study, the degree of variability in case type and complexity made interpretation of the results difficult.…”

Section: Discussionmentioning

confidence: 83%

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The impact of a dedicated operating room team on robotic transplant program growth and fellowship training

Hill,

Scherer,

Kiani

et al. 2023

Clinical Transplantation

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IntroductionDespite considerable interest in robotic surgery, successful incorporation of robotics into transplant programs has been challenging. Lack of a dedicated OR team with expertise in both robotics and transplant is felt to be a major barrier. This paper assesses the impact of a dedicated robotic transplant team (DART) on program growth and fellowship training at one of the largest robotic transplant programs in North America.MethodsThis is a single center, retrospective review of all robotic operations performed on the transplant surgery service from October 2017 to October 2022. DART was incorporated in February 2020 and included transplant first assists (RFAs), scrub technologists and circulating nurses who received robotic training. Robotic experience before and after DART was compared to assess its impact on program growth and training.ResultsFour hundred and two robotic cases were performed by five transplant surgeons: 63 pre‐DART and 339 post‐DART. 40% of cases were transplant‐related and 59.5%, HPB. There was a significant increase in case volume (2.5–10.6 cases/month, p < .0001) and complexity (36.5% vs. 70.3% high complexity cases, p < .0001) post‐DART. RFA case coverage increased from 17% to 95%, and participation of transplant fellows as primary surgeons increased from 17% to 95% post‐DART period (both p < .05). Conversion rates (9.5% vs. 4.1%) and room turn‐around‐times (TAT) (58.4 vs. 40.3 min) were lower post‐DART (p < .05). There were no emergent conversions, conversions in transplant patients, or robot‐related complications in either group.ConclusionOR teams with expertise in robotics and transplant surgery can accelerate growth of robotic transplant programs while maintaining patient safety.

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Section: Discussionmentioning

confidence: 83%

“…Other studies have shown increased efficiency with a specialized team via decreased operating times, a phenomenon that has been called "the assistant effect". 9,10 Although this association was of interest in this study, the degree of variability in case type and complexity made interpretation of the results difficult.…”

Section: Discussionmentioning

confidence: 97%

The impact of a dedicated operating room team on robotic transplant program growth and fellowship training

Hill,

Scherer,

Kiani

et al. 2023

Clinical Transplantation

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“…Out of the 76 publications that met our inclusion criteria, we found that operating with a specialized [23][24][25][26][27][28][29][30][31][32], stable and dedicated surgical team [5,8,27,[33][34][35][36][37][38][39][40][41][42][43], and optimizing the operating schedule [44][45][46], in a room dedicated to the specialty [47][48][49][50][51][52][53], leads to improved outcomes. The optimization of teamwork [34,44,[54][55][56][57][58][59], as quantified using scales such as OTAS (observational teamwork assessment for surgery), NOTSS (non-technical skills for surgeons), and SPLINTS (scrub practitioners' list of intraoperative non-technical skills), was found to potentially reduce operative time without affecting the complication rate. Poor teamwork [55,57], on the other hand, could increase the cost of care …”

Section: Discussionmentioning

confidence: 99%

Operating room organization and surgical performance: a systematic review

Pasquer,

Ducarroz,

Lifante

et al. 2024

Patient Saf Surg

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Background Organizational factors may influence surgical outcomes, regardless of extensively studied factors such as patient preoperative risk and surgical complexity. This study was designed to explore how operating room organization determines surgical performance and to identify gaps in the literature that necessitate further investigation. Methods We conducted a systematic review according to PRISMA guidelines to identify original studies in Pubmed and Scopus from January 1, 2000 to December 31, 2019. Studies evaluating the association between five determinants (team composition, stability, teamwork, work scheduling, disturbing elements) and three outcomes (operative time, patient safety, costs) were included. Methodology was assessed based on criteria such as multicentric investigation, accurate population description, and study design. Results Out of 2625 studies, 76 met inclusion criteria. Of these, 34 (44.7%) investigated surgical team composition, 15 (19.7%) team stability, 11 (14.5%) teamwork, 9 (11.8%) scheduling, and 7 (9.2%) examined the occurrence of disturbing elements in the operating room. The participation of surgical residents appeared to impact patient outcomes. Employing specialized and stable teams in dedicated operating rooms showed improvements in outcomes. Optimization of teamwork reduced operative time, while poor teamwork increased morbidity and costs. Disturbances and communication failures in the operating room negatively affected operative time and surgical safety. Conclusion While limited, existing scientific evidence suggests that operating room staffing and environment significantly influences patient outcomes. Prioritizing further research on these organizational drivers is key to enhancing surgical performance.

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“…Если предположить, что профессиональная медсестра в РА хирургиивполне реальная перспектива, то профессиональный ассистент -намного более сложная задача ввиду особенностей этого раздела хирургии. Позиция ассистента в РА хирургии своеобразна тем, что требует хороших навыков ЛС хирургии и не приближает врача к позиции консольного хирурга [27].…”

Section: г и н е к о л о г и я | G Y N E C O L O G Yunclassified

Comparative analysis of robot-assisted and laparoscopic operations in oncogynecology

Alimov,

Grekov,

Novikova

et al. 2024

Opuholi ženskoj reproduktivnoj sistemy

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Aim. To determine the advantages and disadvantages of laparoscopic (LS) and robot-assisted (RA) surgery in oncogynecological operations.Materials and methods. 282 clinical cases were retrospectively analyzed. The patients were treated in oncogynecological department No. 70 of the CS.P. Botkin City Clinical Hospital, Moscow Healthcare Department for endometrial cancer of stages IA–II, cervical cancer in situ and IA1 stages or atypical endometrial hyperplasia in the period from February 2020 to September 2022, among them 74 patients were operated with Da Vinci robotic units (models Si and Xi) and 208 using laparoscopy. The standard volumes of surgical treatment, depending on the clinical diagnosis, were: hysterectomy, hysterectomy with pelvic lymphadenectomy, hysterectomy with pelvic and retroperitoneal lumbar lymphadenectomy. To compare the technical characteristics of minimally invasive operations and the condition of patients in the intra- and postoperative periods in each group, data on the duration of operations, body mass index, age, intra- and postoperative complications, as well as the number of postoperative hospital bed-days were analyzed.Results. When comparing the average duration of operations by time, a statistically significant difference was obtained. Thus, LS hysterectomy was performed 43 minutes faster on average than RA (74.2 minutes versus 117 minutes) (p <0.001). When performing pelvic lymphadenectomy, the average duration of RA operations was 28 minutes longer than LS operations (142 minutes versus 170 minutes), and when adding the retroperitoneal lymphadenectomy stage, the average duration of RA operations was 128 minutes longer than LS operations.Conclusion. At this stage of technology development in surgery, LS operations have a number of advantages over RA ones in numerous ways. LS operations demonstrate statistically significantly shorter execution time, fewer perioperative complications, as well as a more controlled environment in the operating field. In the long term, RA surgery has serious potential and is currently at an early stage of its development. A real and sober assessment of its characteristics will determine the right direction for the development of this technology in the future.

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Optimizing the robotic surgery team: an operations management perspective

Cited by 6 publications

References 20 publications

The impact of a dedicated operating room team on robotic transplant program growth and fellowship training

The impact of a dedicated operating room team on robotic transplant program growth and fellowship training

Operating room organization and surgical performance: a systematic review

Comparative analysis of robot-assisted and laparoscopic operations in oncogynecology

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