Exploring the Impact of the Physical Environment on Robotic-Assisted Surgery Outcomes and Processes: A Scoping Review

ObjectiveThe purpose of this scoping review is to identify physical environmental facilitators and barriers related to performing robotic-assisted surgery (RAS) in operating rooms (ORs).BackgroundAs new robotic surgery technology is developed and brought to market, there is a need to understand how existing and future operating rooms are adapted and designed to support patient safety, surgical workflow, and teamwork. This review will focus on literature related to physical environment factors that impact workflow and communication, as well as the adoption of RAS technology.MethodThe scoping review search was conducted during November 2022, following the PRISMA guidelines. An independent reviewer screened articles for inclusion and exclusion and two independent reviewers completed a quality appraisal was on the included articles.ResultsOf the 9325 texts screened, 28 articles were included for analysis. The primary physical environment and outcome variables were extracted and synthesized under the following categories: RAS process or task-related, environmental features, environmental qualities, and staff or patient outcomes.ConclusionThe physical environment of the OR, such as OR layout, OR size, environmental noise, and dedicated robotic ORs played a significant role in efficiency and workflow outcomes for RAS, as well as workload measures, staff and patient safety, and surgical performance.ApplicationSince there are minimal evidence-based resources available for the application of RAS, this review provides distinct connections between RAS outcomes and specific environmental features for considerations among design researchers, architects, human factors professionals, hospital administrators, and practitioners to aid in decision making during and after implementation of RAS technology.