Using a Checklist in Robotic‐Assisted Laparoscopic Radical Prostatectomy Procedures

Abstract

Robotic surgical systems are relatively new in New Zealand and have been used mainly for laparoscopic radical prostatectomy. Checklists are successfully used in other industries and health care facilities, so we developed a checklist for use during robotic-assisted laparoscopic radical prostatectomy (RALRP) procedures. After a two-month trial using the checklist, we calculated the completeness of each phase of the checklist as a percentage of the number of completed checklists versus total number of compliant checklists in that phase. Operating room personnel participated in an audiotaped focus group and discussed their perceptions about using the RALRP checklist. We collected, transcribed, and reviewed the focus group discussion and thematically analyzed the responses, which confirmed that the checklist served as a guideline and reminder during the setup. Additionally, staff members associated the checklist with improved OR readiness, minimized workflow interruption, improved efficiency, and positive changes in confidence and teamwork.

Integrative Literature Review Examining Factors Affecting Patient Safety With Robotic‐Assisted and Laparoscopic Surgeries

“…The study characteristics are presented in Table S2. Six of the 12 studies reviewed focused on laparoscopic procedures (Al‐Hakim, ; Hafford et al., ; Murji et al., ; Sevdalis, Hull, & Birnbach, ; Silvennoinen, Antikainen, & Mecklin, ; Stavroulis, Cutner, & Liao, ) and 6 focused on robotic‐assisted surgeries (Allers et al., ; Catchpole et al., ; Friedman, Lendvay, & Hannaford, ; Jing & Honey, ; McCarroll et al., ; Randell et al., ). Six studies used a qualitative methodology, all of which used thematic data analysis with the exception of Silvennoinen et al.…”

“…Three studies used direct observational methods (Al‐Hakim, ; Catchpole et al., ; Sevdalis et al., ), while two studies combined video‐recording observations with another method (Allers et al., ; Silvennoinen et al., ). Two studies analyzed records (Friedman et al., ; McCarroll et al., ); two used interviews (Jing & Honey, ; Randell et al., ), and three used questionnaires (Hafford et al., ; Murji et al., ; Stavroulis et al., ) to collect the data. In surgeries of laparoscopic focus, the participants for three of the studies involved operating room personnel and surgeons (Hafford et al., ; Murji et al., ; Stavroulis et al., ).…”

“…Two studies reported on safety issues based on an examination of patient records ( n = 210) and databases yielding documentation of 565 instrument failures (Friedman et al., ; McCarroll et al., ). Two studies highlighted information obtained from 92 operating room personnel (Jing & Honey, ; Randell et al., ). Six countries were represented across the reviewed studies, with the greater number of studies carried out in the United States.…”

“…Five of the 12 studies reviewed highlighted how human and organizational factors affect the safety of the surgical patient during robotic‐assisted and laparoscopic surgery. Overall, the robotic surgical efficiency and safety improved with increased knowledge, skills, and familiarity with equipment and procedures (Allers et al., ; Catchpole et al., ; Hafford et al., ; Jing & Honey, ; McCarroll et al., ). However, Hafford et al.…”

Anesthesia Professionals’ Perspectives of Teamwork During Robotic‐Assisted Surgery

“…A checklist for the start‐up phase of RAS that includes everyone involved could be beneficial, with an assigned coordinator in charge. This checklist, covering aspects not included in previous checklists, may positively affect communication and cooperation, improve efficiency and workflow, and enhance patient safety . The team would be able to identify important tasks more easily and provide a predictable series of tasks for all members of the team.…”