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World Journal of Surgery

, Volume 42, Issue 11, pp 3599–3607 | Cite as

Effects of Flow Disruptions on Mental Workload and Surgical Performance in Robotic-Assisted Surgery

  • Jeannette Weber
  • Ken Catchpole
  • Armin J. Becker
  • Boris Schlenker
  • Matthias Weigl
Original Scientific Report

Abstract

Background

Robotic systems introduced new surgical and technical demands. Surgical flow disruptions are critical for maintaining operating room (OR) teamwork and patient safety. Specifically for robotic surgery, effects of intra-operative disruptive events for OR professionals’ workload, stress, and performance have not been investigated yet. This study aimed to identify flow disruptions and assess their association with mental workload and performance during robotic-assisted surgery.

Methods

Structured expert-observations to identify different disruption types during 40 robotic-assisted radical prostatectomies were conducted. Additionally, 216 postoperative reports on mental workload (mental demands, situational stress, and distractions) and performance of all OR professionals were collected.

Results

On average 15.8 flow disruptions per hour were observed with the highest rate after abdominal insufflation and before console time. People entering the OR caused most flow disruptions. Disruptions due to equipment showed the highest severity of interruption. Workload significantly correlated with severity of disruptions due to coordination and communication.

Conclusions

Flow disruptions occur frequently and are associated with increased workload. Therefore, strategies are needed to manage disruptions to maintain OR teamwork and safety during robotic-assisted surgery.

Notes

Acknowledgements

We thank all surgeons, nurses and anesthetists for their participation.

Funding

The study was supported by the Munich Centre for Health Sciences (MC-Health) and the Bavarian Research Alliance (BAYFOR).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

268_2018_4689_MOESM1_ESM.docx (20 kb)
Supplementary material 1 (DOCX 19 kb)

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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Jeannette Weber
    • 1
    • 2
    • 5
  • Ken Catchpole
    • 3
  • Armin J. Becker
    • 4
  • Boris Schlenker
    • 4
  • Matthias Weigl
    • 1
  1. 1.Institute and Outpatient Clinic for Occupational, Social and Environmental MedicineLudwig-Maximilians-University MunichMunichGermany
  2. 2.Institute for Medical Informatics, Biometry and EpidemiologyLudwig-Maximilians-University MunichMunichGermany
  3. 3.Department of Anesthesia and Perioperative MedicineMedical University of South CarolinaCharlestonUSA
  4. 4.Department of Urology, University Hospital GrosshadernLudwig-Maximilians-University MunichMunichGermany
  5. 5.Institute of Occupational, Social and Environmental Medicine, Centre for Health and SocietyHeinrich-Heine-University DüsseldorfDüsseldorfGermany

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