Robotic-assisted surgery and the need for standardized pathways and clinical guidelines

Robotic surgical techniques are revolutionizing the way surgery is performed in an effort to improve patient outcomes. Although current literature is limited, studies have shown that patients who undergo robotic-assisted procedures experience reduced surgical time, scarring, blood loss, pain, infection rates, and lengths of stay compared with patients who undergo open or laparoscopic procedures. Currently, start-up costs for robotic systems are high and include the major equipment purchase as well as supplemental equipment purchases and staff member training. There is a need to develop standardized perioperative procedures or clinical guidelines that define optimal application of robotic-assisted surgery to ensure a standard of care that is consistent across procedures and operators. Implementing a clinical pathway or guideline that is guided by evidence-based practice will involve change. Lewin's 1947 basic change theory and the Marker umbrella model may be of use to help facilitate change.