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Work-system interventions in robotic-assisted surgery: a systematic review exploring the gap between challenges and
Falisha Kanji1, Ken Catchpole2, Eunice Choi1
1Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd Suite 8215NT, Los Angeles, CA, 90048, USA.
Surgical Endoscopy
|January 5, 2021
Summary
Robotic assisted surgery (RAS) has many identified barriers to safety and efficiency, but few tested solutions exist. Future research must focus on evaluating interventions for RAS to improve operating room dynamics and patient outcomes.
Area of Science:
- Surgical Technology
- Human Factors Engineering
- Patient Safety
Background:
- Robotic assisted surgery (RAS) introduces complex work-system dynamics with potential for both success and failure.
- Numerous barriers to RAS safety and efficiency are documented, including communication issues, coordination failures, and equipment malfunctions.
- A significant gap exists between identified RAS barriers and implemented solutions.
Purpose of the Study:
- To identify the disparity between documented work-system barriers in RAS and the interventions developed to address them.
- To review existing literature on system-level interventions for RAS.
Main Methods:
- A systematic literature search was conducted across PubMed, Web of Science, and Ovid Medline.
- Included articles published between 1985 and 2020, focusing on system-level interventions for RAS, excluding technical skill-based interventions.
- 30 articles were ultimately included in the review.
Main Results:
- Only 7 out of 30 articles (23.33%) reported implemented and evaluated interventions for RAS.
- The majority of articles (76.67%) offered suggested, unevaluated interventions.
- Key identified barriers included disruptions, ergonomics, safety, efficiency, communication, and non-technical skills, with common suggested solutions like team training and workspace redesign.
Conclusions:
- A significant gap between identified RAS issues and evaluated solutions persists.
- Future research should prioritize the development and evaluation of interventions targeting RAS-specific challenges.
- Improving non-technical skills, task management, and technology management in RAS is crucial for enhanced efficiency, cost reduction, and better system-level outcomes.
