Development of a Surgical Safety Training Program and Checklist for Conversion during Robotic Partial Nephrectomies

Area of Science:

• Urology
• Surgical Education
• Patient Safety

Background:

• Open conversion (OC) during robotic-assisted partial nephrectomy (RAPN) is a rare but critical event.
• Effective teamwork is crucial for managing intraoperative emergencies during RAPN.

Purpose of the Study:

• To assess the impact of standardized training and institutional checklists on improving surgical team performance during RAPN complications.
• To evaluate the effectiveness of different training sequences (simulation-first vs. training-first) on managing emergencies.

Main Methods:

• Two groups of surgical teams participated in simulated emergencies requiring open conversion from RAPN.
• Group 1 performed simulations before training; Group 2 underwent training before simulations.
• Time to conversion and procedural errors were recorded and analyzed.

Main Results:

• Both groups showed decreased errors and time to conversion with increased simulations.
• The training-first group (Group 2) demonstrated a trend towards faster conversion times.
• Lack of task sequence and sterility breaches were more frequent in the simulation-first group (Group 1).

Conclusions:

• Training protocols can enhance teamwork and facilitate timely open conversions during RAPN emergencies.
• Robotic surgery teams require preparation for intraoperative emergencies.
• Further studies are necessary to validate the clinical safety impact of these training protocols.