Quality of Communication in Robotic Surgery and Surgical Outcomes

Abstract

Background and Objectives:Robotic surgery has introduced unique challenges to surgical workflow. The association between quality of communication in robotic-assisted laparoscopic surgery and surgical outcomes was evaluated.Methods:After each gynecologic robotic surgery, the team members involved in the surgery completed a survey regarding the quality of communication. A composite quality-of-communication score was developed using principal component analysis. A higher composite quality-of-communication score signified poor communication.Objective parameters, such as operative time and estimated blood loss (EBL), were gathered from the patient's medical record and correlated with the composite quality-of-communication scores.Results:Forty robotic cases from March through May 2013 were included. Thirty-two participants including surgeons, circulating nurses, and surgical technicians participated in the study. A higher composite quality-of-communication score was associated with greater EBL (P = .010) and longer operative time (P = .045), after adjustment for body mass index, prior major abdominal surgery, and uterine weight. Specifically, for every 1-SD increase in the perceived lack of communication, there was an additional 51 mL EBL and a 31-min increase in operative time. The most common reasons reported for poor communication in the operating room were noise level (28/36, 78%) and console-to-bedside communication problems (23/36, 64%).Conclusion:Our study demonstrates a significant association between poor intraoperative team communication and worse surgical outcomes in robotic gynecologic surgery. Employing strategies to decrease extraneous room noise, improve console-to-bedside communication and team training may have a positive impact on communication and related surgical outcomes.

The process of nurse adaptation to robotic surgery: A qualitative study

“…Nurses should be prepared for situations that require a transition to open surgery, and they should have competence in this regard. For this reason, a systematic approach can be adopted that allows nurses to be prepared for robotic device errors and avoid consequences that may potentially harm the patient . In one study, it was stated that patient safety can be improved by instituting training programs for thoracic robotic surgery nurses .…”

“…For this reason, a systematic approach can be adopted that allows nurses to be prepared for robotic device errors and avoid consequences that may potentially harm the patient. 17 In one study, it was stated that patient safety can be improved by instituting training programs for thoracic robotic surgery nurses. 18 In the current study, it was found that nurses had insufficient information about their expected roles and that this caused stress in nurses during surgery.…”

Anticipation, teamwork and cognitive load: chasing efficiency during robot-assisted surgery

“…Prior studies were limited by the utilisation of questionnaires that may be subject to recall and subjective biases, or simulated surgical scenarios rather than the real operative environment. While simulations can provide an insight about the possible consequences of such factors, studying the real operative environment would offer more accurate depictions of the workload and challenges that face the OR staff during RAS 28. Our methodology allowed for detailed analysis of anticipation and inconvenience events in a real RAS setting and assessed the impact on team performance.…”

Impacts of Telemanipulation in Robotic Assisted Surgery

“…A meta review of teamwork in health care [40] shows evidence that the staff's perception of teamwork affect quality and safety of patient care, and that communication, coordination, and leadership support effective teamwork. In robotic-assisted MIS, poor communication has been correlated to higher estimated blood loss and longer operative times, mainly due to the high noise and console-to-bedside communication issues [61].…”