Robotic‐Assisted Surgery and the Need for Standardized Pathways and Clinical Guidelines

Abstract

Robotic surgical techniques are revolutionizing the way surgery is performed in an effort to improve patient outcomes. Although current literature is limited, studies have shown that patients who undergo robotic-assisted procedures experience reduced surgical time, scarring, blood loss, pain, infection rates, and lengths of stay compared with patients who undergo open or laparoscopic procedures. Currently, start-up costs for robotic systems are high and include the major equipment purchase as well as supplemental equipment purchases and staff member training. There is a need to develop standardized perioperative procedures or clinical guidelines that define optimal application of robotic-assisted surgery to ensure a standard of care that is consistent across procedures and operators. Implementing a clinical pathway or guideline that is guided by evidence-based practice will involve change. Lewin's 1947 basic change theory and the Marker umbrella model may be of use to help facilitate change.

Perioperative Nurses’ Work Experience With Robotic Surgery

“…This finding suggests that a standardized nursing documentation form specific to robotic surgery should be developed, utilizing standardized perioperative procedures or clinical guidelines based on evidence-based practice for robotic-assisted surgery to ensure quality care. 6 The use of surgical safety checklists could improve safety by detecting potential safety hazards, decreasing surgical complications, and improving patient outcomes and communication among staff. [20][21][22] In this study, we used participants' subjective statements about safety checks for robotic surgery.…”

“…4,5 Although this robotic surgery system is not available in healthcare facilities worldwide, its use will be expanded because of anticipated improved outcomes. 6 The introduction of new technologies, robotic surgery in particular, has most strongly affected intraoperative nursing roles, requiring special training in accordance with these expanding roles. 7,8 For example, knowledge and use of a team approach and clinical team skills, which improve with the number of performed surgeries, 9 are essential for the prevention of adverse events and enhancement of patient safety.…”

Perceptions and experiences of perioperative nurses and nurse anaesthetists in robotic‐assisted surgery

“…Many participants proposed standardisation of education and practice for RALS. Currently, there is a lack of standardised education and training of surgeons and nurses involved in RALS (Hafford et al, ; Sood et al, ; Walters & Eley, ). Each individual hospital determines the level of education and practice of the healthcare practitioners involved in RALS.…”

A Journey into the Technical Evolution of Neuroendoscopy

“…With robotic-assisted surgery, the surgeon sits at the console while manipulating the robotic arm during an operation to provide accurate manipulation of the instrument (e.g., the endoscope) (85). It provides surgeons with precise localization of the endoscopic instrument and manipulation without physical tremor if used without the robotic system.…”

“…Other robotic systems for neuroendoscopy known to date are the da Vinci Surgical System and the Mazor Robotics Renaissance. The da Vinci Surgical System (Intuitive Surgical Inc., Sunnyvale, California, USA) consists of 3 instrument arms, 1 endoscopic arm, a joystick for manipulation of the instrument, a monitor with 3D view, and pedals to adjust simultaneously the focus ( Figure 10) (85). The Mazor Robotics Renaissance (Mazor Robotics Ltd., Orlando, Florida, USA) as a navigation system is reported to assist with spinal surgery with increased accuracy and lower radiation exposure (64).…”