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Optimizing the robotic surgery team: an operations management perspective.

Oz Harmanli1, Senay Solak2, Armagan Bayram3

  • 1Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University Yale School of Medicine, New Haven, CT, USA. oz.harmanli@yale.edu.

International Urogynecology Journal
|September 9, 2020
PubMed
Summary

Optimizing surgical team experience in robotically assisted sacrocolpopexy (RASCP) significantly reduces operating room time. The surgical technologist and first assistant roles are most critical for efficient robotic procedures.

Keywords:
EfficiencyOptimizationPelvic organ prolapseRobotic surgerySacrocolpopexyTeamwork

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Area of Science:

  • Urogynecology
  • Minimally Invasive Surgery
  • Robotic Surgery

Background:

  • Pelvic organ prolapse (POP) management often involves robotically assisted sacrocolpopexy (RASCP).
  • Optimizing operating room (OR) time is crucial for efficiency in robotic procedures.

Purpose of the Study:

  • To determine the experience threshold for each surgical team member to optimize OR time in RASCP.
  • To identify the most efficient team compositions for RASCP.

Main Methods:

  • Prospective database of 359 women undergoing RASCP for stage III-IV POP.
  • Statistical analyses including factor analysis, regression, and ANOVA were used.
  • OR time mapping and stochastic optimization identified optimal team configurations.

Main Results:

  • Optimal experience levels: surgeon (44), first assistant (13), surgical technologist (66), circulating nurse (56), anesthesia provider (46).
  • Surgical technologist and first assistant experience significantly impacted OR time.
  • Surgeon experience ranked third, followed by circulating nurse and anesthesia provider.

Conclusions:

  • Operating time in robotic surgery is influenced by multiple factors, with team member experience being critical.
  • Optimal team composition for RASCP can be achieved through various combinations of experience levels.