Room Size Influences Flow in Robotic-Assisted Surgery

Area of Science:

• Surgical Technology
• Operating Room Management
• Human Factors in Medicine

Background:

• Robotic-assisted surgery (RAS) introduces large equipment into operating rooms (ORs).
• The spatial implications and workspace demands of RAS are often overlooked.
• Surgical flow disruptions (FDs) can negatively impact procedure efficiency and safety.

Purpose of the Study:

• To investigate the relationship between operating room (OR) size and environmental causes of surgical flow disruptions (FDs) during robotic-assisted surgery (RAS).
• To identify how OR dimensions influence the occurrence of FDs at different surgical phases.

Main Methods:

• Observational study of 56 RAS procedures across general, urologic, and gynecologic specialties.
• Data collected at two academic hospitals between July 2019 and January 2021.
• Multiple regression analysis used to assess the impact of room size and site on FDs.

Main Results:

• Room size significantly affected FDs in the pre-docking phase (p=0.035), with larger rooms correlating with increased disruptions.
• Room size also significantly affected FDs in the docking phase (p=0.016), with smaller rooms correlating with increased disruptions.
• Hospital site was a significant factor in both pre-docking (p=0.000) and docking (p=0.000) phases.

Conclusions:

• Operating room size presents unrecognized spatial challenges for robotic-assisted surgery integration.
• The physical dimensions of the OR influence surgical workflow and the frequency of disruptions.
• Consideration of technological spatial needs is crucial before implementing new surgical systems.