Jeannette Weber1,2,3, Ken Catchpole4, Armin J Becker5, Boris Schlenker5, Matthias Weigl6. 1. Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University Munich, Munich, Germany. jeannette.weber@uni-duesseldorf.de. 2. Institute for Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany. jeannette.weber@uni-duesseldorf.de. 3. Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich-Heine-University Düsseldorf, Universitätsstraße 1, 40225, Düsseldorf, Germany. jeannette.weber@uni-duesseldorf.de. 4. Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, USA. 5. Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians-University Munich, Munich, Germany. 6. Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University Munich, Munich, Germany.
Abstract
BACKGROUND: Robotic systems introduced new surgical and technical demands. Surgical flow disruptions are critical for maintaining operating room (OR) teamwork and patient safety. Specifically for robotic surgery, effects of intra-operative disruptive events for OR professionals' workload, stress, and performance have not been investigated yet. This study aimed to identify flow disruptions and assess their association with mental workload and performance during robotic-assisted surgery. METHODS: Structured expert-observations to identify different disruption types during 40 robotic-assisted radical prostatectomies were conducted. Additionally, 216 postoperative reports on mental workload (mental demands, situational stress, and distractions) and performance of all OR professionals were collected. RESULTS: On average 15.8 flow disruptions per hour were observed with the highest rate after abdominal insufflation and before console time. People entering the OR caused most flow disruptions. Disruptions due to equipment showed the highest severity of interruption. Workload significantly correlated with severity of disruptions due to coordination and communication. CONCLUSIONS: Flow disruptions occur frequently and are associated with increased workload. Therefore, strategies are needed to manage disruptions to maintain OR teamwork and safety during robotic-assisted surgery.
BACKGROUND: Robotic systems introduced new surgical and technical demands. Surgical flow disruptions are critical for maintaining operating room (OR) teamwork and patient safety. Specifically for robotic surgery, effects of intra-operative disruptive events for OR professionals' workload, stress, and performance have not been investigated yet. This study aimed to identify flow disruptions and assess their association with mental workload and performance during robotic-assisted surgery. METHODS: Structured expert-observations to identify different disruption types during 40 robotic-assisted radical prostatectomies were conducted. Additionally, 216 postoperative reports on mental workload (mental demands, situational stress, and distractions) and performance of all OR professionals were collected. RESULTS: On average 15.8 flow disruptions per hour were observed with the highest rate after abdominal insufflation and before console time. People entering the OR caused most flow disruptions. Disruptions due to equipment showed the highest severity of interruption. Workload significantly correlated with severity of disruptions due to coordination and communication. CONCLUSIONS: Flow disruptions occur frequently and are associated with increased workload. Therefore, strategies are needed to manage disruptions to maintain OR teamwork and safety during robotic-assisted surgery.
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