Abstract: PD46-09
Sources of Funding: Roswell Park Alliance Foundation

Introduction

Communication inaccuracies are a major cause of surgical errors in the operation room. The incorporation of relatively new technology such as robot-assisted surgery (remoteness) may render communication even more challenging. We sought to investigate and analyze the different ways the surgeon communicates with bedside assistants during Robot-assisted Surgery.

Methods

We retrospectively reviewed video and audio recordings of 9 robot-assisted radical prostatectomies enrolled in “Techno-fields” project. Surgical environment was recorded by 3 cameras and lapel microphones recorded the audio from surgical team members. We identified 5 common tasks carried out by console surgeon and categorized the commands used for each request based on the information delivered (Table 1). We also determined the frequency, time to complete each requests, inconveniences and repetitions. Inconveniences were reported if further clarification was needed to perform required action. The most efficient request was the one that with the shortest duration to accomplish the task. Requests were grouped as complete or incomplete. Complete instructions were identified as the most comprehensive detailed request.

Results

431 requests were identified during the study. For instrument change, the most frequently and most efficient request was specifying the instrument and the arm (66%) (Mean time 16 seconds). For clipping and suction, the command without further instructions (e.g. “clip” or “suck”) were the most efficient (9.3 and 4.0). For retraction specifying the direction of retraction showed the least repetitions and inconveniences and was also the most efficient. While comparing complete vs incomplete requests, complete requests had shorter time to perform (7.93 vs 9.24) fewer inconveniences (14 vs 20) but needed more repetitions (8 vs 4).

Conclusions

Properly crafted codes of communications were efficient, took shorter time to accomplish and were associated with less inconveniences and repetitions.

Funding

Roswell Park Alliance Foundation