Training in the protocol for robotic undocking for life emergency support (RULES) improves team communication, coordination and reduces the time required to decouple the robotic system from the patient

Abstract

Introduction Robotic surgery has expanded on it's surgical application and it is also noted an increase in surgical procedures complexity. Occurrence of emergency situations that require conversion of the minimally invasive access route to open access routes is uncommon. The urgent undocking of the robotic platform is a complex and neglected process in robotic surgery training. Objective To establish specific actions and comands for a safe emergency robotic undocking in a simulation environment. Method Two surgical teams, interventional group (IG) and control group (CG), were submitted to a simulation environment in which there was a need for emergency undocking of the robotic system. The intervention group underwent training with the robotic undocking for life emergency support (RULES) protocol. Result Undocking time of the robotic platform from the IG was reduced by 66% and the CG by only 20%. After RULES protocol training, during the second simulation, the IG acquired more critical actions necessary for emergency undocking and developed more non‐technical skills. Conclusion The RULES protocol proved to be effective, promoting an improvement in technical and non‐technical skills of all surgical team menbers, resulting in more effective actions that resut in a coordinated and faster robotic undocking. It is also concluded that the surgeon and bed side surgeon are the key elements for the efficient robotic system undocking in emergency situations.

Robotic Evaluation and Repair of Penetrating Injury of the Abdominal Wall

“…The consensus statement from WSES for emergent general robotic surgery recommends strict patient selection, use only in hemodynamically stable patients, and only if expertise is available [ 4 ]. It has been demonstrated that robot undocking and conversion to open surgery in cases of life-threatening emergencies can be performed swiftly by adequately trained personnel [ 6 ].…”