The Impact of a Dedicated Robotic Team on Robotic-Assisted Sacrocolpopexy Outcomes

Carter-Brooks, Charelle M.; Du, Angela L.; Bonidie, Michael; Shepherd, Jonathan

doi:10.1097/spv.0000000000000413

Cited by 25 publications

(13 citation statements)

References 14 publications

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“…The robot-assisted surgery is a dedicated technique, so the learning curve is also important for surgeons, especially for the beginners. In 2018, Carter-Brooks CM et al found that the dedicated robotic team decreased operative time significantly by 26 minutes during robotic-assisted sacrocolpopexy with a 17.7% reduction [ 12 ]. Geller et al believed that after 20 surgeries, the total time required for RASC surgery was significantly reduced [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Robotic-Assisted Laparoscopic Sacrocolpopexy for Pelvic Organ Prolapse: A Single Center Experience in China

Ning

Zhai

Fan

et al. 2022

Journal of Healthcare Engineering

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Objective. The aim is to investigate the efficiency and outcome of robotic-assisted sacrocolpopexy (RASC) in a cohort of patients with pelvic organ prolapse (POP) in our Gynecology Department. Methods. We performed a retrospective study of female patients who underwent RASC in Chinese PLA General Hospital from January 2013 to December 2020. Their clinical features included age, degree of prolapse, menopause time, body mass index, pregnancy, delivery, operation time, and bleeding volume. All patients were followed up for more than 6 months. POP-Q was recorded to evaluate the position of prolapsed organs. PFDI-20, PFIQ-7, and PGI-I were used to evaluate the life quality after surgery. Results. Twenty-four patients with POP received RASC in our center. The intraoperative bleeding was 86.9 ± 98.3 ml (20–300 ml). The operation time was 143.5 ± 47.3 min (60–240 minutes). The hospitalization time was 10.4 ± 2.1 days (8–16 days). And the follow-up time was 40.8 ± 22.0 months (6–72 months). In the POP-Q follow-up, postoperative Aa, Ba, Ap, Bp, and C were significantly improved than those before surgery ( P < 0.05 ). The objective and subjective cure rate was 100%. PGI-I score was very good in 9 (9/24), very good in 10 (10/24), and good in 3 (3/24). Postoperative PFDI-20 and PFIQ-7 were 2.78 ± 3.82 and 1.57 ± 3.86, which decreased dramatically after surgery ( P < 0.05 ). Mesh exposure occurred in 4 cases (16.7%) at 2–12 months. The exposed diameters were less than 1 cm in 3 cases (2 A/T3/S1) and 1-2 cm in 1 case (3 B/T3/S1). These mesh exposures healed after conservative observation or mesh excision. Conclusion. RASC for POP has the advantage of less bleeding and hospitalization time. It is a minimally invasive option for pelvic organ prolapse.

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Section: Discussionmentioning

confidence: 99%

Robotic-Assisted Laparoscopic Sacrocolpopexy for Pelvic Organ Prolapse: A Single Center Experience in China

Ning

Zhai

Fan

et al. 2022

Journal of Healthcare Engineering

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“…In two smaller studies without control groups, few complications were recorded, and no difference was found before and after implementing the intervention. The subject of the studies was a dedicated robotic team who underwent CRM training plus coaching [ 15 , 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…Four studies looked at readmission rates [ 15–18 ]. None of these found a significant difference in readmission rates between the intervention (treated by dedicated team) and control groups over time.…”

Section: Resultsmentioning

confidence: 99%

Dedicated teams to optimize quality and safety of surgery: A systematic review

Lentz

Wijngaarden

Willeboordse³

et al. 2022

International Journal for Quality in Health Care

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Background A dedicated operating team is defined as a surgical team consisting of the same group of people working together over time, optimally attuned in both technical and/or communicative aspects. This can be achieved through technical and/or communicative training in a team setting. A dedicated surgical team may contribute to the optimization of healthcare quality and patient safety within the perioperative period. Method A systematic review was conducted to evaluate the effects of a dedicated surgical team on clinical and performance outcomes. MEDLINE and Embase were searched on 23 June 2022. Both randomized controlled trials (RCTs) and non-randomized studies (NRSs) were included. Primary outcomes were mortality, complications and readmissions. Secondary outcomes were costs and performance measures. Results Fourteen studies were included (RCTs n = 1; NRSs n = 13). Implementation of dedicated operating teams was associated with improvements in mortality, turnover time, teamwork, communication and costs. No significant differences were observed in readmission rates and length of hospital stay. Results regarding duration, glitch counts and complications of surgery were inconclusive. Limitations include study conduct and heterogeneity between studies. Conclusions The institution of surgical teams who followed communicative and/or technical training appeared to have beneficial effects on several clinical outcome measures. Dedicated teams provide a feasible way of improving healthcare quality and patient safety. A dose–response effect of team training was reported, but also a relapse rate, suggesting that repetitive training is of major concern to high-quality patient care. Further studies are needed to confirm these findings, due to limited level of evidence in current literature. Prospero registration number CRD42020145288

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“…Carter, et al 22 , en otro estudio con seguimiento de 1 año, compararon la sacrocolpopexia robótica y por laparotomía (n = 17 y n = 71, respectivamente) en pacientes con prolapso en estadio III, y encontraron tiempos menos prolongados en la cirugía robótica (131 vs. 160 minutos), así como menores tasas de readmisión, recurrencias, días de estancia hospitalaria y complicaciones asociadas. Si se entrena a un equipo quirúrgico en la realización de cirugía robótica y sacrocolpopexia, y solo realiza este tipo de cirugía, los resultados son excelentes en términos de tiempo operatorio, que disminuye casi media hora cuando se compara con el mismo procedimiento con equipos quirúrgicos no exclusivos para el procedimiento 22 .…”

Section: Sacrocolpopexiaunclassified

Cirugía robótica en ginecología: revisión de la literatura

Rivas-López¹,

Sandoval-García-Travesí²

2020

CIRU

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La cirugía robótica conlleva el potencial de transformar la cirugía laparoscópica al proporcionar, por primera vez, instrumentos con extremos distales que imitan los intrincados movimientos de la mano humana, mientras que al mismo tiempo proporciona al cirujano una alta definición con visión tridimensional del campo operatorio. Objetivo: Describir la aplicación clínica de la cirugía robótica en padecimientos ginecológicos benignos, así como los componentes del sistema robótico Da Vinci Si, analizando las ventajas y desventajas que este tipo de abordaje quirúrgico brinda a la paciente y a su vez al cirujano. Método: Revisión de la bibliografía en PubMed y UpToDate buscando las palabras clave de nuestra revisión. Criterios de inclusión: artículos de casos o series que contuvieran los apartados de la aplicación de la cirugía robótica en ginecología y resultados clínicos. Resultados: Se encontraron 50 artículos científicos que incluían en sus títulos las palabras clave de nuestra revisión. Se descartaron 22 artículos, 14 por ser inaccesibles, tres debido a que estaban publicados en boletines sin factor de impacto y cinco porque no se obtuvo información sobre los resultados del investigador, su volumen, visibilidad y estructura. Se escogieron para esta revisión 28 artículos. Conclusiones: La cirugía robótica ha evolucionado hasta ser un campo aparte, con un enorme potencial para su futuro desarrollo. Los resultados muestran que esta tecnología es aplicable y capaz de ofrecer un adecuado tratamiento a pacientes seleccionadas.

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The Impact of a Dedicated Robotic Team on Robotic-Assisted Sacrocolpopexy Outcomes

Abstract: A dedicated robotic team during robotic-assisted sacrocolpopexy significantly decreased operative time by 26 minutes, a 17.7% reduction at our institution.

Cited by 25 publications

References 14 publications

Robotic-Assisted Laparoscopic Sacrocolpopexy for Pelvic Organ Prolapse: A Single Center Experience in China

Robotic-Assisted Laparoscopic Sacrocolpopexy for Pelvic Organ Prolapse: A Single Center Experience in China

Dedicated teams to optimize quality and safety of surgery: A systematic review

Cirugía robótica en ginecología: revisión de la literatura

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