A Prospective, Observational, Multicentre Study Concerning Nontechnical Skills in Robot-assisted Radical Cystectomy...

Area of Science:

• Surgical Education
• Minimally Invasive Surgery
• Patient Safety

Background:

• Nontechnical skills (NTS) are crucial for surgical success, impacting patient outcomes beyond technical proficiency.
• Robot-assisted surgery (RAS) presents unique communication and teamwork challenges due to the surgeon's remote console position.
• Limited data exists on NTS assessment methods and their relationship with outcomes in RAS.

Purpose of the Study:

• To evaluate and compare nontechnical skills (NTS) in open radical cystectomy (ORC) versus robot-assisted radical cystectomy (RARC).
• To hypothesize that RAS introduction initially decreases team NTS, but experienced RAS teams may exhibit superior NTS compared to experienced open surgery teams.
• To explore the development of distinct NTS behaviors in RAS compared to ORC.

Main Methods:

• Prospective, observational, multicenter case-control study of bladder cancer patients undergoing ORC or RARC.
• Utilized five NTS assessment methods (NOTSS, Oxford NOTECHS II, OTAS, ICARS, human factors analysis) and two technical skills assessment methods for RARC (GEARS, GERT).
• Statistical analysis included frequency statistics, Shapiro-Wilk test, independent sample t-tests, Mann-Whitney U testing, and binary logistic regression.

Main Results:

• This study aims to provide detailed data on NTS during ORC and RARC through structured video analysis.
• The research will compare NTS across different surgical approaches and experience levels.
• Technical skills in RARC will be analyzed using intracorporeal footage to correlate with NTS.

Conclusions:

• The study's structured approach to NTS analysis in ORC and RARC will yield valuable data on skill behavior.
• Results could inform the development of targeted team-training programs for surgical robot implementation.
• Further analysis of technical skills in RARC will elucidate the interplay between surgical skills and NTS.