Current investigation and cause analysis for the interruptions of DaVinci robotic surgery
Objective To analyze the frequency,distribution,and outcomes of interruption events in DaVinci robotic surgery,and to provide experience and reference for exploring the management of DaVinci robotic surgery.Methods DaVinci robotic surgical team at General Hospital of Eastern Theater Command,Shao Yifu Hospital Affiliated to Zhejiang University School of Medicine and Taizhou People's Hospital from December 2022 to September 2023 was observed.The specific content of the surgery interruption events were recorded by using Delphi method to construct a questionnaire on DaVinci robot surgery interruption events.Statistical analysis was conducted using SPSS software.Results A total of 139 elective surgeries were investigated,with a total of 368 hours,and 1 458 interruptions were recorded,with an average interruption rate of 3.96 times per hour.The factors that interrupt the learning process were ranked from high to low as follows:communication factors(353 times),material factors(282 times),and teaching factors(256 times).The most frequent interruptions suffered by the roving nurses were 648 times,surgical assistants were 226 times,and the main surgeon was 150 times.The most likely interruption was from the beginning of anesthesia to the robot docking stage,with(8.23±1.18)times per hour.The results of the interruptions were 589 near misses,523 negative events,and 346 positive events.The interruptions caused by equipment factors and material factors were mostly negative outcomes.Conclusion Robotic surgical interruptions are prevalent and most likely to occur between the onset of anesthesia and the robotic docking phase.Surgical interruptions severely reduce the efficiency of operating room,and the necessary measures need to be taken to reduce the incidence of interruptions.It is important to identify the interruptions that lead to negative outcomes for surgical safety.
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