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Şenol Çelik S, Tunçbilek Z, Sarıköse S, Topaktaş G, Canda AE. Roles, experience and views of nurses working in robotic surgery settings: A mixed-methods study. J Perioper Pract 2024; 34:248-256. [PMID: 38606911 DOI: 10.1177/17504589241231100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Robotic-assisted surgery has benefits for patients, but there are challenges to working in this field. In Turkey, training is not provided for nurses working in robotic-assisted surgery, and national legislation on nurses' roles in these settings has not been implemented. This study aimed to demonstrate the roles and experiences of nurses in robotic-assisted surgery in Turkey. This study was conducted as a mixed-methods research. The qualitative data were analysed by content analysis. More than half of the nurses had received basic training in robotic-assisted surgery. Qualitative data consisted of five themes, including the effects of robotic surgery, feelings and thoughts on robotic surgery, working as a nurse in robotic surgery settings, responsibilities of nurses and competence of nurses working in robotic surgery settings. Determining the working conditions and roles of nurses working in robotic-assisted surgery settings by policymakers in regulations is crucial for improving the quality of nursing care and the outcomes of patients.
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Affiliation(s)
| | | | | | - Gülsen Topaktaş
- Department of Education and Certification, Ministry of Health, Ankara, Turkey
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2
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Tou S, Au S, Clancy C, Clarke S, Collins D, Dixon F, Dreher E, Fleming C, Gallagher AG, Gomez-Ruiz M, Kleijnen J, Maeda Y, Rollins K, Matzel KE. European Society of Coloproctology guideline on training in robotic colorectal surgery (2024). Colorectal Dis 2024; 26:776-801. [PMID: 38429251 DOI: 10.1111/codi.16904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 01/14/2024] [Indexed: 03/03/2024]
Affiliation(s)
- Samson Tou
- Department of Colorectal Surgery, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
- School of Medicine, University of Nottingham, Derby, UK
| | | | - Cillian Clancy
- Department of Colorectal Surgery, Tallaght University Hospital, Dublin, Ireland
| | - Steven Clarke
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Danielle Collins
- Department of Colorectal Surgery, Western General Hospital, NHS Lothian, Edinburgh, Scotland
| | - Frances Dixon
- Department of Colorectal Surgery, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK
| | - Elizabeth Dreher
- Department of Urology, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Christina Fleming
- Department of Colorectal Surgery, University Hospital Limerick, Limerick, Ireland
| | | | - Marcos Gomez-Ruiz
- Colorectal Surgery Unit, General Surgery Department, Marqués de Valdecilla University Hospital, Santander, Spain
- Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain
| | - Jos Kleijnen
- Kleijnen Systematic Reviews Ltd, York, UK
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Yasuko Maeda
- Department of Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Katie Rollins
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
| | - Klaus E Matzel
- Section of Coloproctology, Department of Surgery, University of Erlangen-Nürnberg, FAU, Erlangen, Germany
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3
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Lee L, Greenway K, Schutz S. What do nurses experience in communication when assisting in robotic surgery: an integrative literature review. J Robot Surg 2024; 18:50. [PMID: 38280076 PMCID: PMC10822005 DOI: 10.1007/s11701-024-01830-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/14/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Communication in surgery is integral to the fundamentals of perioperative nursing practice and patient safety. Research exploring team communication in robotic-assisted surgery (RAS) is evident in the literature but little attention has been focused on how the experiences of operating room nurses' communication affect safety, practice and patient care outcomes. OBJECTIVE To synthesise current evidence regarding communication during robotic-assisted surgery as experienced by registered nurses. DESIGN An integrative literature review informed by Whittemore and Knafl's (2005) methodology was used to conduct a rigorous analysis and synthesis of evidence. METHODS A comprehensive database search was conducted using PRISMA guidelines. CINAHL, Pubmed, PsychINFO and British Nursing Web of Science databases were searched using a Boolean strategy. RESULTS Twenty-five relevant papers were included in this literature review. Thematic analysis revealed two main themes with four related subthemes. The two main themes are: 'Adaptive operating room nursing in RAS' and 'RAS alters team dynamics'. The four subthemes are: 'Navigating disruptions in RAS', 'RAS heightens interdependence on team working', 'Augmented communicative workflow in RAS', and 'Professional empowerment to speak up'. CONCLUSIONS This integrative review identifies how current research largely focuses on communication in the wider OR team. However, current evidence lacks the input of nurses. Therefore, further evidence is needed to explore nurses' experiences to highlight their perspectives. CLINICAL RELEVANCE Robotics significantly benefit patients, and this review identifies different challenges that robotic-assisted surgery nurses encounter. A better understanding of the communication from the perspective of nurses is needed to guide future research, practice education, policy development and leadership/management.
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Affiliation(s)
- Lian Lee
- Oxford Brookes University, Oxford, UK.
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4
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Wright R. Clinical Issues - October 2023. AORN J 2023; 118:267-272. [PMID: 37750801 DOI: 10.1002/aorn.14008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 09/27/2023]
Abstract
Pregnant personnel in the magnetic resonance environment Key words: magnetic resonance (MR), pregnant personnel, zone IV, exposure, scanner. Patients with tattoos in the magnetic resonance environment Key words: tattoo ink, permanent cosmetic tattoo, magnetic resonance (MR), scanning, burns. Robotic procedure emergency preparedness Key words: emergency readiness, conversion to open, robotic surgery, checklists, undocking. Communication during robotic procedures Key words: communication, teamwork, robotic procedures, familiarity, perioperative team.
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Hayashi H, Hirahara N, Matsubara T, Takao S, Okamura H, Nakamura K, Kishi T, Taniura T, Zotani H, Ishitobi K, Tajima Y. Duplicate left gastric artery identified during robot-assisted distal gastrectomy: a case report. Surg Case Rep 2023; 9:148. [PMID: 37610522 PMCID: PMC10447737 DOI: 10.1186/s40792-023-01698-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/13/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Duplicated left gastric artery (LGA) is a rare anomaly. With an incidence of only 0.4%, its clinical significance remains largely unrecognized. CASE PRESENTATION A 65-year-old man underwent robot-assisted distal gastrectomy for early gastric cancer. After division of the left gastric vein in the left gastropancreatic fold, a slim LGA (LGA-1) was identified and dissected. Careful dissection of the left gastropancreatic fold toward the root of the celiac artery revealed another LGA (LGA-2), which was dissected without difficulty. Postoperative reevaluation of the three-dimensional-computed tomography (CT) angiography reconstructed using the preoperative CT scan identified a 2.7 mm LGA-1, branching from the splenic artery, and a 3.0 mm LGA-2, branching from the celiac artery. To the best of our knowledge, this is only the third reported case of a duplicate LGA in a patient who underwent laparoscopic gastrectomy. Our case is the first to report the use of robot surgery. CONCLUSIONS Although duplicate LGA is rare and receives little clinical attention, surgeons should keep this vascular anomaly in mind during preoperative evaluation since there is an increased risk for intraoperative bleeding during gastrectomy.
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Affiliation(s)
- Hikota Hayashi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enya-Cho, Izumo, Shimane 693-8501 Japan
| | - Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enya-Cho, Izumo, Shimane 693-8501 Japan
| | - Takeshi Matsubara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enya-Cho, Izumo, Shimane 693-8501 Japan
| | - Satoshi Takao
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enya-Cho, Izumo, Shimane 693-8501 Japan
| | - Hiroki Okamura
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enya-Cho, Izumo, Shimane 693-8501 Japan
| | - Kosuke Nakamura
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enya-Cho, Izumo, Shimane 693-8501 Japan
| | - Takashi Kishi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enya-Cho, Izumo, Shimane 693-8501 Japan
| | - Takahito Taniura
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enya-Cho, Izumo, Shimane 693-8501 Japan
| | - Hitomi Zotani
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enya-Cho, Izumo, Shimane 693-8501 Japan
| | - Kazunari Ishitobi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enya-Cho, Izumo, Shimane 693-8501 Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enya-Cho, Izumo, Shimane 693-8501 Japan
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Redondo-Sáenz D, Cortés-Salas C, Parrales-Mora M. Perioperative Nursing Role in Robotic Surgery: An Integrative Review. J Perianesth Nurs 2023:S1089-9472(22)00594-9. [PMID: 36754770 DOI: 10.1016/j.jopan.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 09/25/2022] [Accepted: 11/06/2022] [Indexed: 02/10/2023]
Abstract
PURPOSE Robotic surgery is an increasingly popular approach across surgical specialties in several countries. Nurses embedded in this highly-technological environment, however, could excessively center their attention to the robot, deviating their focus from the patient. The Perioperative Patient Focused Model is proposed as a theoretical framework to guide nursing perioperative care towards a patient-centered approach based upon 4 dimensions: Health System, Safety, Behavioral Responses and Physiological Responses. This review aimed to understand the role of perioperative nursing in robotic surgery according to the Perioperative Patient Focused Model. DESIGN An integrative review. METHODS The Whittemore and Knafl methodology guided this review. The following databases were searched: PubMed, Cochrane Library, ProQuest, Scielo, and LILACS. The keywords used were "Robotic Surgical Procedures" and "Nursing" and their equivalents in Spanish, Portuguese, and French, using the Boolean operator "AND," within the time frame of 2010-2021. FINDINGS A total of 1,695 articles were retrieved, of which 26 were retained for the final analysis. The majority (n = 17) were written in English, with a level of evidence between 4 and 5. The main actions performed by nursing professionals were retrieved in the Health Systems, Safety, and Behavioral Responses dimensions, focusing on the intraoperative and postoperative period. However, most of the patient's responses were presented in the postoperative stage, even after discharge. Encompassing these findings, a theoretical framework is proposed. CONCLUSIONS Nursing professional duties are diverse within the course of robotic surgery. It is necessary to expand the Perioperative Nursing specialty towards an extended care, encompassing even the community settings.
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Affiliation(s)
| | | | - Mauricio Parrales-Mora
- Hepato-Pancreato-Biliary (HPB) Surgery Unit, Germans Trias i Pujol University Hospital, Autonomous University of Barcelona, Barcelona, Spain
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7
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Senol Celik S, Ozdemir Koken Z, Canda AE, Esen T. Experiences of perioperative nurses with robotic-assisted surgery: a systematic review of qualitative studies. J Robot Surg 2022; 17:785-795. [DOI: 10.1007/s11701-022-01511-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/10/2022] [Indexed: 12/24/2022]
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8
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Huang TL, Wu CN, Lee IC, Wong AMK, Shyu YIL, Ho LH, Liao GY, Teng CI. How robots impact nurses' time pressure and turnover intention: A two-wave study. J Nurs Manag 2022; 30:3863-3873. [PMID: 35862237 DOI: 10.1111/jonm.13743] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/30/2022] [Accepted: 07/20/2022] [Indexed: 12/30/2022]
Abstract
AIMS To examine the relationships among effort ensuring robots' smooth operation (EERSO), time pressure, missed care, and nurses' turnover intention, and how robot performance moderates such relations. BACKGROUND Robots may reduce nurses' workload but typically still require some effort of nurses for robots' smooth operation. However, the negative impact of EERSO on nurses' workplace outcomes is unknown. METHODS This study used a two-wave follow-up design. Data were collected in a medical center in Taiwan, with first wave collected in 2019 and second wave collected between 2019 and 2020. A total of 331 participants were followed through the two waves. RESULTS EERSO is positively linked to missed care and time pressure. Time pressure is also positively linked to missed care and turnover intention. Positive robot performance weakens the positive link between EERSO and time pressure. CONCLUSION Using robots may help reduce nurses' workload, but it also requires nurses' efforts to maintain robots' continuous operation, that is, EERSO. It may adversely impact nursing professional workplaces. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers should reduce nurses' time pressure whilst suggest hospital managers to seek robots that require minimal EERSO.
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Affiliation(s)
- Tzu-Ling Huang
- Graduate Institute of Management, Chang Gung University, Taoyuan, Taiwan
| | - Chieh-Ni Wu
- Department of Industrial and Business Management, Chang Gung University, Taoyuan, Taiwan
| | - I-Chen Lee
- Department of Industrial and Business Management, Chang Gung University, Taoyuan, Taiwan.,Craniofacial Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | | | | | - Lun-Hui Ho
- Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan.,Adjunct Lecturer, Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Gen-Yih Liao
- Department of Information Management, Chang Gung University, Taoyuan, Taiwan.,Department of Nursing, Chang Gung Memorial Hospital, Taoyuan Branch, Taoyuan, Taiwan
| | - Ching-I Teng
- Graduate Institute of Management, Chang Gung University, Taoyuan, Taiwan.,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Business and Management, Ming Chi University of Technology, Taiwan
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9
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Arad D, Finkelstein A, Rozenblum R, Magnezi R. Perceptions of surgical never events among interdisciplinary clinicians: Implications of a qualitative study for practice. Collegian 2022. [DOI: 10.1016/j.colegn.2022.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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10
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Gillespie BM, Gillespie J, Boorman RJ, Granqvist K, Stranne J, Erichsen-Andersson A. The Impact of Robotic-Assisted Surgery on Team Performance: A Systematic Mixed Studies Review. HUMAN FACTORS 2021; 63:1352-1379. [PMID: 32613863 DOI: 10.1177/0018720820928624] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The aim of this study is to describe the impact of robotic-assisted surgery on team performance in the operating room. BACKGROUND The introduction of surgical robots has improved the technical performance of surgical procedures but has also contributed to unexpected interactions in surgical teams, leading to new types of errors. METHOD A systematic literature search of Cumulative Index to Nursing and Allied Health Literature, PubMed, ProQuest, Cochrane, Web of Science, PsycINFO, and Scopus databases using key words and MeSH terms was conducted. Screening identified studies employing qualitative and quantitative methods published between January 2000 and September 2019. Two reviewers independently appraised the methodological quality of the articles using the Mixed Methods Appraisal Tool (2018). Discussions were held among authors to examine quality scores of the studies and emergent themes, and agreement was reached through consensus. Themes were derived using inductive content analysis. RESULTS Combined searches identified 1,065 citations. Of these, 19 articles, 16 quantitative and 3 qualitative, were included. Robotic-assisted surgeries included urology, gynecology, cardiac, and general procedures involving surgeons, anesthetists, nurses, and technicians. Three themes emerged: Negotiating the altered physical environs and adapting team communications to manage task and technology; managing the robotic system to optimize workflow efficiency; and technical proficiency depends on experience, team familiarity, and case complexity. CONCLUSION Inclusion of a robot as a team member adds further complexity to the work of surgery. APPLICATION These review findings will inform training programs specifically designed to optimize teamwork, workflow efficiency, and learning needs.
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Affiliation(s)
- Brigid M Gillespie
- School of Nursing & Midwifery & Menzies Institute of Health, Brisbane, QLD, Australia
- Gold Coast Hospital and Health Service, QLD, Australia
| | | | - Rhonda J Boorman
- School of Nursing & Midwifery & Menzies Institute of Health, Brisbane, QLD, Australia
| | - Karin Granqvist
- 3570Sahlgrenska Academy, Institute of Health & Caring Sciences, University of Gothenburg, Sweden
| | - Johan Stranne
- Sahlgrenska University Hospital, Gothenburg, Sweden
- 3570University of Gothenburg, Sweden
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Kalipershad SNR, Peristerakis I. The introduction of an emergency safety protocol coupled with simulation training in robotic surgery, has enabled a more cohesive and efficient response to emergencies. Surgeon 2021; 20:151-156. [PMID: 33947630 DOI: 10.1016/j.surge.2021.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/04/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022]
Abstract
With the increasing popularity of robotic surgery, arise a unique set of challenges. In-order to minimise the risk and optimise patient safety, teams need to anticipate these, plan and train to improve familiarity with the nuances of robotic surgery. Human factors and simulation training (ST) are now an integral part of surgery and we have extended these principles to our robotic practice. From our experience with emergencies and a thorough debrief, we have realised the importance of an emergency safety protocol (ESP) for the undocking of the robot, and how training with the correct systems in place optimises our non-technical skills and improves our efficiency. This protocol is used across all robotic specialties allowing for clear communication, situational awareness and role clarity, thereby reducing errors in a high-pressured environment. We aim to share our protocol, highlight the importance of ST and show that coupling of the ESP with ST, including addressing a disrupted power supply and how to avoid the resulting loss of image capture, is where our paper contributes to the current literature. There is a paucity in the literature regarding emergency undocking, and also techniques for avoiding power interruptions, for which we utilise the Uninterruptible Power Supply (UPS) system. By sharing experiences and systems used, we create an opportunity that will result in a culture of shared learning in the robotic community, thereby encouraging other robotic teams to review their protocols and training practices and adapt as necessary.
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Affiliation(s)
- Sujala N R Kalipershad
- Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, Lancashire, UK.
| | - Ioannis Peristerakis
- Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, Lancashire, UK.
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12
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Intercultural readiness of nursing students: An integrative review of evidence examining cultural competence educational interventions. Nurse Educ Pract 2021; 50:102966. [PMID: 33454512 DOI: 10.1016/j.nepr.2021.102966] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 12/31/2020] [Indexed: 01/24/2023]
Abstract
With the mounting reports of culturally insensitive care and the reported challenges nurses experience when caring for culturally diverse patients, developing the intercultural readiness of nursing students is a necessity. However, little is known as to the success of cultural competence educational interventions in undergraduate nursing curricula and there remains a lack of consensus within the literature as to how it should be structured, organised and facilitated. Incorporating an integrative review method, this study synthesised international research on educational interventions used in preparing student nurses to care for culturally diverse patients. A systematic literature search of all published studies between 2013 and 2017, in CINAHL, Scopus, Medline, PubMed, Embase, Cochrane, Education Source and PsycINFO databases were performed. The PRISMA checklist was used to guide the review process. Six hundred and twenty-four studies were screened for eligibility and the analysis of the fourteen included studies are presented within two overarching themes; increasing knowledge and understanding and developing commitment and confidence. Engaging student nurses in learning activities that augment their understanding of, and commitment to, providing culturally competent care must include a variety of integrated culturally responsive pedagogical approaches made explicit and continuously developed across all learning opportunities.
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13
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Baloul MS, Yeh VJH, Mukhtar F, Ramachandran D, Farley DR, Rivera M. Video Commentary: Rapid-Fire Assessment of Surgical Cognitive Skills. JOURNAL OF SURGICAL EDUCATION 2021; 78:351-355. [PMID: 32709571 DOI: 10.1016/j.jsurg.2020.06.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/04/2020] [Accepted: 06/28/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE We describe the use of "Video Commentary", an assessment using a set of operative videos, to assess trainees' surgical cognitive skills (operative knowledge, spatial awareness, and surgical insight). DESIGN & SETTING The Video Commentary assessment has been routinely administered to Postgraduate Year (PGY) 1-5 general surgery residents since 2014 as part of a biannual multistation, OSCE-type exam at Mayo Clinic, Rochester, MN. Video Commentary is a rapid-fire, 6-minute assessment, where trainees watch a series of 20 to 30 second operative video clips and comment on them as they play. Each clip varies in procedure, approach, difficulty, and complexity. The combination of video clips differs according to trainees' PGY level except for a few videos that overlap among PGY groups. The name of the procedure is provided at the beginning of each clip with a countdown timer showing in the corner of the screen. A comprehensive checklist is used to score trainees' performance in real-time. DISCUSSION Assessment of trainees of different levels and staff surgeons show a positive correlation with the experience level (p = 0.0001). The assessment provides a safe alternative to assess trainees in the operating room and encourages them to become more effective communicators. With the use of technology, large video databases can be created to provide just-in-time tailored feedback to the trainees. CONCLUSIONS Video Commentary can serve as a time and resource-efficient assessment of trainees' surgical cognitive skills and insight. The use and demand of real-time commentary on operative videos may provide a viable approach to help surgeon educators determine trainees' baseline, progression, and readiness to advance.
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Affiliation(s)
| | - Vicky J-H Yeh
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Fareeda Mukhtar
- Department of Surgery, Mayo Clinic, Rochester, Minnesota; Department of Clinical Skills, Alfaisal University, Riyadh, Saudi Arabia
| | | | - David R Farley
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Mariela Rivera
- Department of Surgery, Mayo Clinic, Rochester, Minnesota.
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14
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Bjøro B, Mykkeltveit I, Rustøen T, Candas Altinbas B, Røise O, Bentsen SB. Intraoperative peripheral nerve injury related to lithotomy positioning with steep Trendelenburg in patients undergoing robotic-assisted laparoscopic surgery - A systematic review. J Adv Nurs 2019; 76:490-503. [PMID: 31736124 DOI: 10.1111/jan.14271] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/08/2019] [Accepted: 11/05/2019] [Indexed: 12/22/2022]
Abstract
AIMS To examine the incidence of intraoperative peripheral nerve injury, symptoms, risk factors, functions, and quality of life in patients undergoing robotic-assisted laparoscopic surgery to lithotomy positioning with steep Trendelenburg. DESIGN A systematic review. DATA SOURCES The Cochrane Library catalogue, PubMed, EMBASE, CINHAL and SveMed + databases were searched from January 2000 - February 2019. REVIEW METHODS Titles and abstracts were screened for inclusion. Full-text assessments of each paper were conducted by two reviewers. The quality of the included papers was assessed using the Mixed Methods Appraisal Tool. Descriptive statistics and thematic analysis were used to synthesize the data. RESULTS Eleven quantitative studies were included with three themes: (a) incidence of intraoperative peripheral nerve injury; (b) upper extremity intraoperative peripheral nerve injury related to steep Trendelenburg positioning; and (c) lower extremity intraoperative peripheral nerve injury related to lithotomy positioning. The overall incidence of intraoperative peripheral nerve injury in robotic-assisted laparoscopic urologic, gynaecologic and colorectal surgery was 0.16%-10.0% and the symptoms appeared immediately after surgical procedures. Risk factors for intraoperative peripheral injury were prolonged operative time, high American Society of Anesthesiologists scores, comorbidities and high body mass index. CONCLUSION Intraoperative peripheral nerve injuries are rare, but occasionally serious when related to lithotomy positioning with steep Trendelenburg. Operating room nurses have a responsibility both for positioning patients and for being familiar with the technological developments that will influence the preoperative handling of patients. IMPACT This systematic review emphasizes the need for operating room nurses together with surgical team to have knowledge about mechanisms for injury, positioning, anatomy/physiology, and evaluation of risk factors to ensure that patients are not exposed for intraoperative peripheral nerve injuries. Increased robotic-assisted laparoscopic surgery necessitates further research examining the incidence of intraoperative peripheral nerve injury related to positioning and how these affect patients' function and the quality of life.
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Affiliation(s)
- Benedikte Bjøro
- Department of Operating Services, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Ida Mykkeltveit
- Faculty of Health Science, University of Stavanger, Stavanger, Norway
| | - Tone Rustøen
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Bahar Candas Altinbas
- Department of Surgical Disease Nursing, Faculty of Health Science, Karadeniz Technical University, Trabzon, Turkey
| | - Olav Røise
- Division of Orthopedics Surgery, Faculty of health Sciences, Oslo University Hospital, SHARE-Center for Resilience in Healthcare, University of Stavanger, Stavanger, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Signe Berit Bentsen
- Department of Operating Services, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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15
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Schuessler Z, Scott Stiles A, Mancuso P. Perceptions and experiences of perioperative nurses and nurse anaesthetists in robotic‐assisted surgery. J Clin Nurs 2019; 29:60-74. [DOI: 10.1111/jocn.15053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/02/2019] [Accepted: 08/24/2019] [Indexed: 01/04/2023]
Affiliation(s)
| | | | - Peggy Mancuso
- College of Nursing Texas Woman's University Denton Texas
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