The introduction of an emergency safety protocol coupled with simulation training in robotic surgery, has enabled a more cohesive and efficient response to emergencies

Training in the protocol for robotic undocking for life emergency support (RULES) improves team communication, coordination and reduces the time required to decouple the robotic system from the patient

“…Kalipershad S.N.R. et al 3 also observed a reduction in the time required for the complete uncoupling of the robotic platform after training and called attention to the need for specific protocols to enhance the responsiveness of the team and improve the skills of each participant.…”

“…1,2 The absence of protocols and training for the immediate conversion to open surgery can impose considerable risks to the patient. 3 The motives to convert from RMIS to open surgery can be categorised into three groups: anaesthetic, surgical and those related to the robotic system. 4 For those conversions motivated by the need for emergency surgical intervention, the determination of the actions required and their implementation need to occur rapidly, especially those related to the decoupling of the robotic system from the patient, so as to avoid potential death during the perioperative period and to remove the physical obstacles to open surgery from the robotic platform itself.…”

“…Kalipershad S.N.R. et al 3 highlighted the importance of non‐technical skills and human factors in emergency situations occurring during robotic surgery. They observed that communication between team members was worse during robotic operations than in surgical procedures by other means, and that communication worsened in periods of stress 6 …”

Safe implementation of a minimally invasive hepatopancreatobiliary program, a narrative review and institutional experience

“…Programs should endeavor to create protocols and interdisciplinary training programs for managing adverse intraoperative events such as major hemorrhage, air embolism, cardiac arrest, and equipment failure. Curricula to train emergency undocking and simulation of intraoperative catastrophes can reduce errors and improve workflow during difficult scenarios 67–69 . For example, the Barnes‐Jewish Hospital/Washington University created an “Emergency Undocking Bleeding Protocol” that delineate team roles to be performed simultaneously during an emergency event 56 .…”

“…Curricula to train emergency undocking and simulation of intraoperative catastrophes can reduce errors and improve workflow during difficult scenarios. [67][68][69] For example, the Barnes-Jewish Hospital/Washington University created an "Emergency Undocking Bleeding Protocol" that delineate team roles to be performed simultaneously during an emergency event. 56 At the time of publication, our group has completed 20 cases utilizing a consistent technique and have internally reviewed and published our outcomes.…”