Wood Thomas Charles, Ovenden Kenneth, Rahman Rumana, Raglan Olivia, Bainton Thomas, Ahmed Jeffrey, Raza Amer
Department of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, Du Cane Road, London, W12 0HS, UK.
Heathrow Airport, London, TW6 2GA, UK.
J Robot Surg. 2025 Jun 8;19(1):275. doi: 10.1007/s11701-025-02440-z.
High-risk industries such as aviation have long since understood that technical competencies alone do not guarantee safety or success. Surgical disciplines including robot-assisted surgery (RAS) have achieved this understanding relatively recently, despite also being considered high-risk. Both disciplines face challenges from technical (TS) and non-technical skill (NTS) perspectives, requiring calm, controlled, and skilled management to overcome adversity. Whilst aviation demonstrates admirable safety records, RAS has been highlighted as a potential health technology hazard. Comparisons are increasingly being drawn between the technology, culture, safety practices, and training modalities of RAS and aviation. Aviation recognises NTS limitations and reflects this through its simulation-based training. Whilst the amended intraoperative dynamics of RAS constitute unique NTS challenges, the inclusion of NTS within formalised RAS training curricula is comparatively negligible. Virtual-reality (VR) simulation in aviation allows pilots to achieve and maintain their TS and NTS competencies. Simulation's role in the development and maintenance of RAS competencies is not treated with parity; however, RAS VR simulation has the potential to improve the feasibility of the integration of simulation with RAS training. The incorporation of aviation-based safety practices in RAS needs further consideration, given that surgery remains behind its high-risk counterparts. RAS stands to benefit from adopting key components of their practices, including work environment, culture, simulation, and the standardisation and regulatory oversight of its training programmes. Through implementing established safety practices utilised in other high-risk industries, RAS has the potential to reduce the frequency and severity of adverse events, with patients becoming the ultimate beneficiaries.
航空等高危行业早就明白，仅靠技术能力并不能保证安全或成功。包括机器人辅助手术（RAS）在内的外科领域直到最近才认识到这一点，尽管它们也被视为高危领域。这两个领域都面临着技术（TS）和非技术技能（NTS）方面的挑战，需要冷静、可控且熟练的管理来克服困难。虽然航空业有着令人钦佩的安全记录，但RAS却被视为一种潜在的健康技术危害。RAS与航空业在技术、文化、安全实践和培训方式等方面的比较越来越多。航空业认识到NTS的局限性，并通过基于模拟的培训来体现这一点。虽然RAS术中动态的改变构成了独特的NTS挑战，但在正式的RAS培训课程中纳入NTS的情况相对较少。航空业的虚拟现实（VR）模拟使飞行员能够获得并保持他们的TS和NTS能力。模拟在RAS能力发展和维持中的作用并未得到同等对待；然而，RAS VR模拟有潜力提高模拟与RAS培训整合的可行性。鉴于外科手术仍落后于其他高危领域，将基于航空业的安全实践纳入RAS需要进一步考虑。RAS有望通过采用其实践的关键组成部分而受益，包括工作环境、文化、模拟以及其培训项目的标准化和监管监督。通过实施其他高危行业采用的既定安全实践，RAS有可能降低不良事件的发生率和严重程度，患者将成为最终受益者。
