In-depth characterization of a laparoscopic radical prostatectomy procedure based on surgical process modeling

Area of Science:

• Urology
• Surgical Technology
• Medical Informatics

Background:

• Minimally invasive surgery, particularly laparoscopic radical prostatectomy, is standard for prostate cancer, preserving erectile function.
• Increasing data in laparoscopic techniques necessitates intelligent systems to filter information for surgeons.
• Standardizing surgical workflows is crucial for context-aware smart assistants.

Purpose of the Study:

• To characterize laparoscopic radical prostatectomy procedures.
• To formalize medical expert knowledge through surgical process modeling (SPM).
• To develop a foundation for context-aware surgical assistants.

Main Methods:

• Manual data acquisition through expert observation and discussion.
• Observation of 14 procedures (manual and robot-assisted laparoscopic radical prostatectomy).
• Development of an Excel template for surgery observation and focus on the intraoperative phase with endoscopic camera feedback.

Main Results:

• A descriptive and numerical surgical process model was generated, including workflow diagrams.
• 11 distinct surgical phases were identified and characterized.
• The model details anatomical structures, surgeons, instruments, and actions per phase, with an average surgery duration of 87 minutes.

Conclusions:

• The developed surgical process model is a foundational step for context-aware surgical assistants.
• This model can serve as a roadmap for research teams, operating room managers, and surgical staff.
• It facilitates the standardization and structuring of surgical workflows for improved intraoperative support.