The decisive role of the patient-side surgeon in robotic surgery

Sgarbură, Olivia; Vasilescu, C

doi:10.1007/s00464-010-1108-9

Cited by 66 publications

(58 citation statements)

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“…Possible explanations include the fact that pioneer surgeons were often experienced laparoscopists, that costs of RA laparoscopy remain high [25], and that the da Vinci Surgical System Ò needs to be refined. The most obvious weaknesses of current robotic system are lack of haptic feedback [51], risk of system malfunction [30], possibility of arm collision [51], inability to reposition the patient once the robot is docked [51], need for a second experienced surgeon at the table [52], intricacy of instrument exchange disrupting the flow of the operation [25], and the limited access to the patient by the anesthesia team in case of exsanguinating hemorrhage [53] or extubation [54]. Further, the advantages of RA may be difficult to demonstrate, in the lack of large prospective data, if technically successful PD can be completed using conventional laparoscopic techniques.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic pancreaticoduodenectomy: a systematic literature review

Amorese²,

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Laparoscopic pancreaticoduodenectomy: a systematic literature review

Amorese²,

et al. 2014

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“…23 The impact of this change in spatial configuration on communication and teamwork in the OT is not a topic that has been explored in previous evaluations of RAS, which have typically focused on the role of the surgeon. 24 Two small studies have looked specifically at differences in communication between laparoscopic surgery and RAS. One study compared communication in eight operations using laparoscopic surgery (four cholecystectomies and four prostatectomies) and 12 using the da Vinci robot (five cholecystectomies and seven prostatectomies).…”

Section: Implications For Practicementioning

confidence: 99%

A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making

Randell

Honey

Hindmarsh

et al. 2017

Health Serv Deliv Res

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Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hsdr This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its preceding programmes as project number 12/5005/04. The contractual start date was in September 2013. The final report began editorial review in September 2016 and was accepted for publication in February 2017. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department...

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“…Robotic surgery is introduced into an already complex, technology rich, safety-critical environment, where team members with diverse training and expertise work together under conditions of time pressure and uncertainty (Flin et al 2007;Pugh et al 2011). While existing evaluations of robotic surgery have focused on the role of the surgeon (Sgarbura and Vasilescu 2010), the complex division of labour in the operating theatre (OT) means that a technology which has consequences for the role of the surgeon will inevitably have consequences for other members of the team. Successful introduction of robotic surgery is likely to involve a process through which OT personnel, both individually and as a group, adapt both the technology and the way that they work (Cook and Woods 1996;Finch et al 2012).…”

Section: Introductionmentioning

confidence: 99%

Embedding robotic surgery into routine practice and impacts on communication and decision making: a review of the experience of surgical teams

et al. 2016

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While an increasing number of healthcare providers are purchasing surgical robots because of anticipated improvements in patient outcomes, their implementation into practice is highly variable. In robotic surgery, the surgeon is physically separated from the patient and the rest of the team with the potential to impact communication and decision making in the operating theatre and subsequently patient safety. Drawing on the approach of realist evaluation, in this article we review reports of the experience of surgical teams that have introduced robotic surgery to identify how and in what contexts robotic surgery is successfully integrated into practice and how and in what contexts it affects communication and decision making. Our analysis indicates that, while robotic surgery might bring about a number of benefits, it also creates new challenges. Robotic surgery is associated with increased operation duration, which has implications for patient safety, but strategies to reduce it can be effective with appropriate support from hospital administration and nursing management. The separation of the surgeon from the team can compromise communication but may be overcome through use of standardised communication. While surgeon situation awareness may be affected by the separation, the ergonomic benefits of robotic surgery may reduce stress and tiredness and enhance surgeon decision making. Our review adds to the existing literature by revealing strategies to support the introduction of robotic surgery and contextual factors that need to be in place for these to be effective.

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The decisive role of the patient-side surgeon in robotic surgery

Abstract: Robotic surgery is a team effort and is greatly dependant on the performance of assistant surgeons. Interventions that have the benefit of a trained team are more rapid and secure.

Cited by 66 publications

References 11 publications

Laparoscopic pancreaticoduodenectomy: a systematic literature review

Laparoscopic pancreaticoduodenectomy: a systematic literature review

A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making

Embedding robotic surgery into routine practice and impacts on communication and decision making: a review of the experience of surgical teams

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