How to reduce intraoperative preparation and docking time to minimal in a team with a robotic naïve surgical experience?

Abstract

Purpose: To evaluate the effect of preoperative training in an experimental setting on the preparation and docking of the avatera robotic system.

Materials and methods: Two different surgical groups (consisting of two nurses, one assistant, and one operating surgeon) attended an initial training on robot draping and docking procedures. Group 1 was involved in 10 robotic-assisted operations while Group 2 was trained in the dry lab using an artificial insufflated abdominal model (10 sessions). The decrease in time needed for docking and draping was evaluated. After the completion of the initial training, each group performed docking and draping procedures in five surgeries (including robotic-assisted radical prostatectomy and pyeloplasty) and the recorded times were compared.

Results: In Group 1, the docking and draping time were diminished during the initial training program from 17 to 7 min and from 12 to 5 min, respectively. In Group 2, the docking time was decreased from 9 to 6 min and the draping time from 8 to 5 min. Both types of training (during real-life OR program vs. dry laboratory setting inclusive an insufflated abdominal model) resulted in nearly the same positive training effect for Group 1 and Group 2, respectively.

Conclusions: Conducing a training of patient preparation and docking in the dry laboratory using an insufflated abdominal model facilitates experience acquisition in a safe and calm environment. The training method of Group 2 might help to avoid the potentially longer anesthesia times for patients during the early learning curve of Group 1.

Keywords: Avatera robotic system; docking; experimental study; learning curve; robot-assisted surgery.