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Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
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Robotically Assisted Thoracic Surgery: Proposed Guidelines for Privileging and Credentialing.

Faiz Y Bhora1, Adnan M Al-Ayoubi, Sadiq S Rehmani

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This study presents a stepwise algorithm for credentialing surgeons in robotically assisted thoracic surgery (RATS). The guidelines ensure safe implementation of RATS by considering surgeon competency, procedure complexity, and outcomes.

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Area of Science:

  • Thoracic Surgery
  • Surgical Technology
  • Medical Credentialing

Background:

  • Robotically assisted thoracic surgery (RATS) adoption is increasing.
  • Effective credentialing is crucial for patient safety in RATS.
  • Existing guidelines for RATS privileges are limited.

Purpose of the Study:

  • To provide a stepwise algorithm for granting RATS privileges and credentials.
  • To establish guidelines reflecting graduated responsibility and procedural complexity.
  • To incorporate surgeon volume, outcomes, competency, and appropriate robot utilization.

Main Methods:

  • Literature review of robotic surgery credentialing strategies.
  • Analysis of institutional and multi-center experiences in the United States.
  • Development of a credentialing algorithm based on evidence and practical experience.

Main Results:

  • Two training pathways exist: residency-trained and nonresidency-trained surgeons.
  • Residency-trained surgeons need 20 cases; nonresidency-trained require simulation, didactics, and observation for provisional privileges.
  • Annual maintenance requires a minimum of 10 cases, with ongoing QA/QI review and IRB approval for investigational use.

Conclusions:

  • Prioritizing safety is essential when introducing new technologies like RATS.
  • The proposed algorithm offers a foundational guideline for institutions establishing RATS programs.
  • The algorithm promotes appropriate use and safe outcomes in RATS.