Train robotic surgery teams regularly by simulating intraoperative emergencies and maintain a dedicated team¶

Strategy · All strategies
Evidence · 8 claims (8 for) · 3 studies (3 review), q2–q3 · 1 of 3 report an effect size · 8 claims rest on one study

Description¶

The review recommends that RAS teams routinely rehearse emergency scenarios such as conversion to open surgery, because team training improves communication, anticipation and patient safety. It states that "Team training on crisis-resource management should be performed regularly by RAS teams even though these are rare events" and that maintaining a dedicated team and addressing environmental factors is important for safe RAS procedures.

Design Implications¶

Context¶

Requirements¶

• A dedicated or core team with special training, per the EAES consensus statement quoted in the review: "Robotic systems need a dedicated team with special training"

Constraints¶

• In hospitals where a devoted team is impractical, the review says it is essential to cultivate a core team of able persons

Target Learners¶

• surgeons
• trainee surgeons
• anaesthetists
• scrub practitioners
• surgical teams

Target Learning Goals¶

• non-technical skills including communication, teamwork, leadership and situational awareness
• emergency response skills such as conversion to open surgery and robotic undocking

Claims¶

• Simulation-based emergency open-conversion training reduced time to conversion and improved leadership and role delineation in robotic prostatectomy teams [+W]
• Higher team anticipation correlates with shorter operative time, while more requests correlate with longer operative time in robotic surgery [+W]
• Perceived deficits in communication quality during robotic surgery are associated with greater estimated blood loss and longer operative time [+W]
• Communication, environmental factors, anticipation and teamwork are the key non-technical skills reported in robotic-assisted surgery [+W]
• Higher NTSRS scores correlate with fewer near-miss events, while surgeon experience does not correlate with NTSRS scores except in decision-making [+W]
• NTS training improves observable team behavioural performance in EDs, including more frequent closed-loop communication, clearer role allocation and prioritisation, improved situational awareness, and higher teamwork ratings (moderate certainty). [+W]
• In one included study, simulation-based team training in a trauma bay was followed by a 16 percent reduction in total resuscitation time and faster completion of primary surveys. [+W]
• Simulation-based training is associated with communication and teamwork gains of approximately 2–3 points and NOTSS domain means of 2.8–3.5 on 4-point scales [+W]

Related Strategies¶

• Structured cross-platform training curriculum combining generalised exposure and platform-specific proficiency

Examples¶

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Key Sources¶

• Mahendran Vimaladhithan, Turpin Laura, Boal Matthew, Francis Nader K. (2024). Assessment and application of non-technical skills in robotic-assisted surgery: a systematic review. Surgical Endoscopy. https://doi.org/10.1007/s00464-024-10713-1