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Ambulatory movements, team dynamics and interactions during robot‐assisted surgery
Author(s) -
Ahmad Nabeeha,
Hussein Ahmed A.,
Cavuoto Lora,
Sharif Mohamed,
Allers Jenna C.,
Hinata Nobuyuki,
Ahmad Basel,
Kozlowski Justen D.,
Hashmi Zishan,
Bisantz Ann,
Guru Khurshid A.
Publication year - 2016
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13426
Subject(s) - ambulatory , workflow , medicine , robot , simulation , physical medicine and rehabilitation , operations management , computer science , surgery , engineering , artificial intelligence , database
Objective To analyse ambulatory movements and team dynamics during robot‐assisted surgery ( RAS ), and to investigate whether congestion of the physical space associated with robotic technology led to workflow challenges or predisposed to errors and adverse events. Methods With institutional review board approval, we retrospectively reviewed 10 recorded robot‐assisted radical prostatectomies in a single operating room ( OR ). The OR was divided into eight zones, and all movements were tracked and described in terms of start and end zones, duration, personnel and purpose. Movements were further classified into avoidable (can be eliminated/improved) and unavoidable (necessary for completion of the procedure). Results The mean operating time was 166 min, of which ambulation constituted 27 min (16%). A total of 2 896 ambulatory movements were identified (mean: 290 ambulatory movements/procedure). Most of the movements were procedure‐related (31%), and were performed by the circulating nurse. We identified 11 main pathways in the OR ; the heaviest traffic was between the circulating nurse zone, transit zone and supply‐1 zone. A total of 50% of ambulatory movements were found to be avoidable. Conclusion More than half of the movements during RAS can be eliminated with an improved OR setting. More studies are needed to design an evidence‐based OR layout that enhances access, workflow and patient safety.