The role of the bedside assistant in robot-assisted surgery: A critical synthesis

Abstract

Introduction: Robot-assisted surgery has grown exponentially since its inception and first approval in the United States in the year 2000. The surgeon operating with the assistance of the robot sits remotely to the patient and another practitioner assists at the bedside. The role of the bedside assistant and the training that is required to undertake this role are understudied topics. Aim: To explore the functions, training and professional development of the bedside assistant in robot-assisted surgery and propose the necessary foundations for the safe enactment of the role in the United Kingdom. Methods: Through critical interpretative synthesis, relevant literature was systematically searched and analysed to inform integration of evidence. Results: Seventy-three studies were retrieved from the literature, across several health care disciplines and surgical specialities. These were critically analysed to inform a theoretically sound account grounded on evidence. Conclusion: The role, functions and skills of the bedside assistant in robot-assisted surgery vary across contexts. These were analysed and critically synthetised to produce several keys to the success of bedside assistants in robot-assisted surgery in the context of the United Kingdom and of its national regulations.

Robotic-assisted laparoscopic radical hysterectomy for early-stage cervical cancer: The more experienced the bedside assistant, the better?

“…Ultimately, it is also worth noting that BA in robotic-assisted laparoscopy could be proficient after 10–36 cases [ 33 , 34 ], which is consistent with the number required in our research. We suppose that a BA in robotic-assisted laparoscopy has a short learning curve, even for an inexperienced BA who also could be proficient rapidly.…”

Experience matters for robotic assistance: an analysis of case data

“…In some cases, the role of the assistant is minimal and limited to bedside instrument exchange, camera cleaning, and port site closure. In other operations, the assistant must provide adept laparoscopic assistance and understand the flow and sequence of the operation at an advanced level [ 2 ]. The assistant’s experience—whether limited as a junior resident or extensive as a fellow—has been posited as important to the success of robotic surgery [ 3 ].…”

“…Bedside assistance is frequently described as a stepping stone on the path to console surgeon [4][5][6]. Prior work has acknowledged the multiple skills required as an assistant, and learning curve analysis has suggested that 10-36 cases are required for proficient bedside assistance [2,7]. However, the actual training of assistants varies [3,6].…”