Emergent robotic surgery conversions: improving operating room team performance through high fidelity simulations

Area of Science:

• Robotic Surgery
• Surgical Education
• Patient Safety

Background:

• Robotic surgery offers benefits but poses safety challenges, particularly concerning intraoperative hemorrhages due to surgeon distance.
• Developing effective training for emergency protocols is crucial for thoracic operating room (OR) teams.

Purpose of the Study:

• To evaluate the impact of a training program on emergency robotic undocking protocol performance in thoracic OR teams.
• To assess whether targeted education improves team response to critical events during robotic surgery.

Main Methods:

• Emergency undocking protocols and checklists were developed for massive hemorrhage scenarios.
• Phase I involved in-situ simulations without protocol knowledge (control).
• Phase II introduced protocols via high-fidelity simulation or didactic sessions to different teams, followed by in-situ testing.

Main Results:

• All teams successfully converted to open surgery within five minutes, with the surgeon at the bedside.
• Phase II teams showed a significant reduction in critical misses (0.25) compared to Phase I (2.55).
• No significant difference was observed in the time for the surgeon to reach the bedside between phases.

Conclusions:

• Targeted education, including high-fidelity simulation and didactic sessions, effectively improves OR team performance in emergency robotic undocking.
• Training programs are vital for enhancing patient safety during robotic-assisted thoracic surgery.