Identifying Workflow Disruptions in Robotic-Assisted Bariatric Surgery: Elucidating Challenges Experienced by Surgical Teams.
Identifying Workflow Disruptions in Robotic-Assisted Bariatric Surgery: Elucidating Challenges Experienced by Surgical Teams.
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DOI：
10.1007/s11695-023-06620-4
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发表时间：
2023-07
期刊：
影响因子：
2.9
通讯作者：
中科院分区：
文献类型：
--
作者：
减肥手术是极端肥胖患者减肥的有效和持久的治疗方法。虽然传统上采用腹腔镜手术，但机器人减肥手术（RBS）对外科医生和患者都有独特的好处。尽管如此，机器人手术的技术复杂性为手术室团队和更广泛的临床系统提出了新的挑战。进一步评估RBS在为肥胖患者提供优质护理方面的作用是必要的，可以通过人为因素的方法来完成。这项观察性研究旨在通过研究流程中断（FD）或与自然工作流程进展的偏离来研究RBS对手术工作系统的影响。在2019年10月至2022年3月期间观察了RBS程序。FD被记录在真实的时间，随后被分类到九个工作系统类别之一。协调FD进一步分为其他子类别。在3个研究中心观察到29例RBS手术。总体上观察到平均FD发生率为25.05（CI = ± 2.77）。注气和机器人对接之间（M = 29.37，CI = ± 4.01）以及患者闭合和轮出之间（M = 30.00，CI = ± 6.03）的FD最高。由于协调问题导致的FD发生率总体上最高，在对接期间每4分钟发生一次（M = 14.28，CI = ± 3.11）。FD大约每2.4分钟发生一次，并且在RBS的最终患者转移和机器人对接阶段最频繁发生。与等待工作人员/仪器不方便和重新调整设备有关的协调挑战是造成这些中断的主要原因。
Bariatric surgery is an effective and durable treatment for weight loss for patients with extreme obesity. Although traditionally approached laparoscopically, robotic bariatric surgery (RBS) has unique benefits for both surgeons and patients. Nonetheless, the technological complexity of robotic surgery presents new challenges for OR teams and the wider clinical system. Further assessment of the role of RBS in delivering quality care for patients with obesity is necessary and can be done through a human factors approach. This observational study sought to investigate the impact of RBS on the surgical work system via the study of flow disruptions (FDs), or deviations from the natural workflow progression. RBS procedures were observed between October 2019 and March 2022. FDs were recorded in real time and subsequently classified into one of nine work system categories. Coordination FDs were further classified into additional sub-categories. Twenty-nine RBS procedures were observed at three sites. An average FD rate of 25.05 (CI = ± 2.77) was observed overall. FDs were highest between insufflation and robot docking (M = 29.37, CI = ± 4.01) and between patient closing and wheels out (M = 30.00, CI = ± 6.03). FD rates due to coordination issues were highest overall, occurring once every 4 min during docking (M = 14.28, CI = ± 3.11). FDs occur roughly once every 2.4 min and happen most frequently during the final patient transfer and robot docking phases of RBS. Coordination challenges associated with waiting for staff/instruments not readily available and readjusting equipment contributed most to these disruptions.
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DOI：
10.3390/ijerph18157984
发表时间：
2021-07-28
影响因子：
--
作者：
Kanji F;Cohen T;Alfred M;Caron A;Lawton S;Savage S;Shouhed D;Anger JT;Catchpole K
通讯作者：
Catchpole K
DOI：
10.4293/jsls.2020.00062
发表时间：
2020-10
期刊：
JSLS : Journal of the Society of Laparoendoscopic Surgeons
影响因子：
--
作者：
Kersebaum JN;Möller T;von Schönfels W;Taivankhuu T;Becker T;Egberts JH;Beckmann JH
通讯作者：
Beckmann JH
DOI：
10.1007/s00464-015-4671-2
发表时间：
2016-09-01
影响因子：
3.1
作者：
Catchpole, Ken;Perkins, Colby;Anger, Jennifer T.
通讯作者：
Anger, Jennifer T.
影响因子：
5.4
作者：
Alfred, Myrtede;Del Gaizo, John;Cohen, Tara
通讯作者：
Cohen, Tara
影响因子：
2.9
作者：
Scarritt, Thomas;Hsu, Chiu-Hsieh;Ghaderi, Iman
通讯作者：
Ghaderi, Iman