机器人辅助手术中工作流程中断的评估与影响
Evaluation and Impact of Workflow Interruptions During Robot-assisted Surgery.
作者信息
Allers Jenna C, Hussein Ahmed A, Ahmad Nabeeha, Cavuoto Lora, Wing Joseph F, Hayes Robin M, Hinata Nobuyuki, Bisantz Ann M, Guru Khurshid A
机构信息
Applied Technology Laboratory for Advanced Surgery (ATLAS), Roswell Park Cancer Institute, Buffalo, NY.
Applied Technology Laboratory for Advanced Surgery (ATLAS), Roswell Park Cancer Institute, Buffalo, NY; Department of Urology, Cairo University, Giza, Egypt.
出版信息
Urology. 2016 Jun;92:33-7. doi: 10.1016/j.urology.2016.02.040. Epub 2016 Mar 7.
OBJECTIVE
To analyze and categorize causes for interruptions during robot-assisted surgery.
METHODS
We analyzed 10 robot-assisted prostatectomies that were performed by 3 surgeons from October 2014 to June 2015. Interruptions to surgery were defined in terms of duration, stage of surgery, personnel involved, reasons, and impact of the interruption on the surgical workflow.
RESULTS
The main reasons for interruptions included the following: console surgeons switching (29%); preparation of the surgical equipment, such as cleaning or changing the camera (29%) or an instrument (27%); or when a suture, stapler, or clip was needed (12%). The most common interruption duration was 10-29 seconds (47.6%), and the least common interruption duration was greater than 90 seconds (3.6%). Additionally, about 14% of the interruptions were considered avoidable, whereas the remaining 86% of interruptions were necessary for surgery.
CONCLUSION
By identifying and analyzing interruptions, we can develop evidence-based strategies to improve operating room efficiency, lower costs, and advance patient safety.
目的
分析并归类机器人辅助手术过程中的中断原因。
方法
我们分析了2014年10月至2015年6月期间由3位外科医生实施的10例机器人辅助前列腺切除术。手术中断根据持续时间、手术阶段、涉及人员、原因以及中断对手术流程的影响来定义。
结果
中断的主要原因如下：控制台外科医生更换（29%）；手术设备的准备，如清洁或更换摄像头（29%）或器械（27%）；或者需要缝合线、吻合器或夹子时（12%）。最常见的中断持续时间为10 - 29秒（47.6%），最不常见的中断持续时间大于90秒（3.6%）。此外，约14%的中断被认为是可避免的，而其余86%的中断对于手术是必要的。
结论
通过识别和分析中断情况，我们可以制定基于证据的策略，以提高手术室效率、降低成本并提升患者安全。
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