The Loud Surgeon Behind the Console: Understanding Team Activities During Robot-Assisted Surgery

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• 作者：Judith Tiferes ; MS^* ; ^&dagger ; ; Ahmed A. Hussein ; MD^&dagger ; ; ^&Dagger ; ; Ann Bisantz ; PhD^* ; Justen D. Kozlowski ; BS^&dagger ; ; Mohamed A. Sharif ; BS^&dagger ; ; Nathalie M. Winder^* ; Nabeeha Ahmad ; BS^&dagger ; ; Jenna Allers^&dagger ; ; Lora Cavuoto ; PhD^* ; Khurshid A. Guru ; MD^&dagger ; ; ^{Khurshid.guru@roswellpark.org" class="auth_mail" title="E-mail the corresponding author} ; ^{ahmed.aly@roswellpark.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：communication ; team interactions ; robot-assisted surgery ; nontechnical skills ; flow ; interruptions
• 刊名：Journal of Surgical Education
• 出版年：2016
• 出版时间：May-June 2016
• 年：2016
• 卷：73
• 期：3
• 页码：504-512
• 全文大小：1518 K

文摘

To design a data collection methodology to capture team activities during robot-assisted surgery (RAS) (team communications, surgical flow, and procedural interruptions), and use relevant disciplines of Industrial Engineering and Human Factors Engineering to uncover key issues impeding surgical flow and guide evidence-based strategic changes to enhance surgical performance and improve outcomes.

Design

Field study, to determine the feasibility of the proposed methodology.

Setting

Recording the operating room (OR) environment during robot-assisted surgeries (RAS). The data collection system included recordings from the console and 3 aerial cameras, in addition to 8 lapel microphones (1 for each OR team member). Questionnaires on team familiarity and cognitive load were collected.

Participants

In all, 37 patients and 89 OR staff members have consented to participate in the study.

Results

Overall, 37 RAS procedures were recorded (130 console hours). A pilot procedure was evaluated in detail. We were able to characterize team communications in terms of flow, mode, topic, and form. Surgical flow was evaluated in terms of duration, location, personnel involved, purpose, and if movements were avoidable or not. Procedural interruptions were characterized according to their duration, cause, mode of communication, and personnel involved.

Conclusion

This methodology allowed for the capture of a wide variety of team activities during RAS that would serve as a solid platform to improve nontechnical aspects of RAS.