PDF(Pubmed)
Abstract：
BACKGROUND: For many years, robotic surgery has been an option for various elective surgical procedures. Though robotic surgery has not traditionally been the first choice for acute surgical patients, recent work has shown promise in broader applications. However, there are limited data regarding how to establish an institutional robotics program for higher acuity patients. This project aimed to map a pathway for the creation of an acute care surgery robotic program at a large academic medical center.
METHODS: Various stakeholders were gathered jointly with our surgical faculty: anesthesia, operating room leadership, surgical technologists, circulating nurses, Central Sterile Supply, and Intuitive Surgical Inc. representatives. Staff underwent robotics training, and surgical technologists were trained as bedside first assistants. Nontraditional robotic operating rooms were allocated for coordinated placement of appropriate cases, and pre-made case carts were arranged with staff to be available at all hours. A workflow was created between surgical faculty and staff to streamline add-on robotic cases to the daily schedule.
RESULTS: Six faculty and two fellows are now credentialed in robotics surgery, and additional surgeons are undergoing training. Numerous staff have completed training to perform operative assistant duties. The operating capacity of robotic acute care surgeries has more than doubled in just one year, from 77 to 172 cases between 2022 and 2023, respectively. Two add-on cases can be accommodated per day. Select patients are being offered robotic surgeries in the acute surgical setting, and ongoing efforts are being made to create guidelines for which patients would best benefit from robotic procedures.
CONCLUSIONS: Launching a successful robotic surgery program requires a coordinated, multidisciplinary effort to ensure seamless integration into daily operations. Additional assistance from outside technology representatives can help to ensure comfort with procedures. Further studies are needed to determine the acute patient population that may benefit most from robotic surgery.
METHODS: Various stakeholders were gathered jointly with our surgical faculty: anesthesia, operating room leadership, surgical technologists, circulating nurses, Central Sterile Supply, and Intuitive Surgical Inc. representatives. Staff underwent robotics training, and surgical technologists were trained as bedside first assistants. Nontraditional robotic operating rooms were allocated for coordinated placement of appropriate cases, and pre-made case carts were arranged with staff to be available at all hours. A workflow was created between surgical faculty and staff to streamline add-on robotic cases to the daily schedule.
RESULTS: Six faculty and two fellows are now credentialed in robotics surgery, and additional surgeons are undergoing training. Numerous staff have completed training to perform operative assistant duties. The operating capacity of robotic acute care surgeries has more than doubled in just one year, from 77 to 172 cases between 2022 and 2023, respectively. Two add-on cases can be accommodated per day. Select patients are being offered robotic surgeries in the acute surgical setting, and ongoing efforts are being made to create guidelines for which patients would best benefit from robotic procedures.
CONCLUSIONS: Launching a successful robotic surgery program requires a coordinated, multidisciplinary effort to ensure seamless integration into daily operations. Additional assistance from outside technology representatives can help to ensure comfort with procedures. Further studies are needed to determine the acute patient population that may benefit most from robotic surgery.
摘要：
背景：多年来，机器人手术已成为各种选择性外科手术的一种选择。虽然传统上机器人手术并不是急性手术患者的首选，最近的工作在更广泛的应用中显示出了希望。然而,关于如何为高敏锐度患者建立机构机器人计划的数据有限。该项目旨在为在大型学术医学中心创建急性护理手术机器人程序绘制路径。
方法：各种利益相关者与我们的外科学院共同聚集：麻醉，手术室领导,外科技师,循环护士,中央消毒供应,和直观外科公司的代表。工作人员接受了机器人培训，外科技术人员接受了床边第一助手的培训。非传统机器人手术室被分配用于协调放置适当的病例，并安排工作人员随时待命。在外科教职员工之间创建了一个工作流程，以简化附加机器人病例的日常时间表。
结果：现在有6名教师和2名研究员获得了机器人手术资格，更多的外科医生正在接受培训。许多工作人员已经完成了执行手术助理职责的培训。在短短一年内，机器人急性护理手术的操作能力增加了一倍多，2022年至2023年期间，分别为77至172例。每天可以容纳两个附加案例。在急性手术环境中为部分患者提供机器人手术，目前正在努力制定指南，使患者能够从机器人手术中获益。
结论：启动成功的机器人手术计划需要协调，多学科的努力，以确保无缝集成到日常运营。来自外部技术代表的额外援助可以帮助确保程序的舒适性。需要进一步的研究来确定可能从机器人手术中受益最多的急性患者群体。
方法：各种利益相关者与我们的外科学院共同聚集：麻醉，手术室领导,外科技师,循环护士,中央消毒供应,和直观外科公司的代表。工作人员接受了机器人培训，外科技术人员接受了床边第一助手的培训。非传统机器人手术室被分配用于协调放置适当的病例，并安排工作人员随时待命。在外科教职员工之间创建了一个工作流程，以简化附加机器人病例的日常时间表。
结果：现在有6名教师和2名研究员获得了机器人手术资格，更多的外科医生正在接受培训。许多工作人员已经完成了执行手术助理职责的培训。在短短一年内，机器人急性护理手术的操作能力增加了一倍多，2022年至2023年期间，分别为77至172例。每天可以容纳两个附加案例。在急性手术环境中为部分患者提供机器人手术，目前正在努力制定指南，使患者能够从机器人手术中获益。
结论：启动成功的机器人手术计划需要协调，多学科的努力，以确保无缝集成到日常运营。来自外部技术代表的额外援助可以帮助确保程序的舒适性。需要进一步的研究来确定可能从机器人手术中受益最多的急性患者群体。
