Team members' reflections in debriefings after simulated robot-assisted surgery

Robot-assisted surgery (RAS) challenges teamwork due to the physical separation of the console surgeon from the rest of the team. In acute situations, such as massive bleeding requiring emergency undocking and conversion to open surgery, effective coordination becomes critical. Existing research on teamwork during acute RAS is limited, and so is research on team reflections about performance, which is essential for improving it. This study aimed to explore how RAS teams reflect on coordination in debriefings following simulated scenarios of massive bleeding.

We conducted a qualitative, explorative study using thematic analysis of six debriefings held after simulation-based RAS scenarios involving massive bleeding. Debriefings were audio-recorded, transcribed, and thematically analysed.

Three main themes were identified: (1) Roles and responsibilities-highlighting the mediating role of the assistant surgeon, perceptions of leadership, and the importance of trust and familiarity; (2) Management of tasks-describing busyness, anticipation, tone during crisis, and hesitation to act; and (3) Management of information-including sub-teams in the team and the need for feedback and information.

Team reflections emphasise role clarity, leadership, anticipating, communication, and coordination in acute RAS situations. These insights are useful for planning simulation-based training that targets these aspects during emergencies in RAS.