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Factors affecting workflow in robot-assisted surgery: a scoping review.

Jannie Lysgaard Poulsen1,2, Birgitte Bruun3, Doris Oestergaard3,4

  • 1Copenhagen Academy for Medical Education and Simulation (CAMES), Center for Human Resources and Education, The Capital Region of Denmark, Copenhagen, Denmark. Jannie.lysgaard.poulsen@regionh.dk.

Surgical Endoscopy
|June 23, 2022
PubMed
Summary

Robot-assisted surgery impacts teamwork and workflow. This review highlights communication, coordination, training, and technology as key factors affecting flow disruptions and non-technical skills in surgical teams.

Keywords:
Flow disruptionsNon-technical skillsRobot-assisted surgeryWorkflow

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Area of Science:

  • Surgical Innovation
  • Human Factors in Medicine
  • Teamwork and Patient Safety

Background:

  • Robot-assisted surgery (RAS) is increasingly adopted globally.
  • Existing research primarily focuses on technical skills and patient outcomes.
  • RAS alters team composition and surgeon proximity, potentially impacting operating room dynamics.

Purpose of the Study:

  • To explore literature on factors affecting workflow in RAS.
  • To investigate team members' social and cognitive skills in RAS.
  • To identify reported challenges in RAS teamwork and workflow.

Main Methods:

  • Systematic search across Medline, EMBASE, PsycINFO, and Web of Science.
  • Screening followed Preferred Reporting Item for Systematic reviews and Meta-Analysis for Scoping Review (PRISMA-ScR) guidelines.
  • Inclusion criteria: RAS, multi-professional teams, workflow, flow disruptions, non-technical skills.

Main Results:

  • 24 articles were included from 12,527 references.
  • Studies focused on flow disruptions (causes/incidences) and non-technical skills (communication, situation awareness).
  • Frequent causes of flow disruptions included communication, coordination, training, and equipment/technology.

Conclusions:

  • Communication, coordination, training, and technology are significant factors in RAS workflow disruptions.
  • Non-technical skills, particularly communication and situation awareness, are critical.
  • Future research should address preventing harmful flow disruptions and developing workflow improvement interventions.