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Recommendations for Emergency Robotic Thoracic Conversions and Intraoperative Resuscitation: A Modified Delphi

Hayley Reddington1, Lana Schumacher2, Ammara A Watkins3

  • 1Division of Thoracic Surgery, Department of Surgery, University of Massachusetts Chan Medical School, Worcester, Massachusetts.

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Summary
This summary is machine-generated.

This consensus study established key principles for emergency robotic thoracic surgery conversions. It identified essential steps like calling for help and using robotic instruments for tamponade, while noting variations in undocking procedures.

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Area of Science:

  • Thoracic Surgery
  • Robotic Surgery
  • Surgical Safety

Background:

  • Emergency conversion events in robotic thoracic surgery present unique challenges.
  • Standardized principles are needed to manage these critical situations effectively.

Purpose of the Study:

  • To determine essential principles and acceptable variations for emergency conversion events in robotic thoracic surgery.
  • To develop consensus-based guidelines for managing intraoperative emergencies.

Main Methods:

  • A modified Delphi study involving 21 expert robotic thoracic surgeons.
  • Two rounds of statement rating using a 5-point Likert scale (≥70% agreement for consensus).
  • Inclusion of preoperative preparation, emergency undocking/resuscitation, and debriefing domains.

Main Results:

  • 100% response rate achieved.
  • Consensus reached on all preoperative preparation and debriefing statements.
  • 16 out of 19 undocking/resuscitation statements achieved consensus; 3 showed insufficient agreement (66.7%).
  • Key consensus principles included conversion indications, calling for help, robotic tamponade, partial undocking, visualization, and team communication.

Conclusions:

  • The achieved consensus provides a foundation for developing protocols for emergency robotic thoracic surgery conversions.
  • Areas of disagreement highlight surgeon- and institution-specific variations that may be acceptable.