Evaluation of time-loss in robot-assisted surgery
Robotic surgery systems were introduced recently to deal with the basic disadvantages of laparoscopic surgery. However, working with these systems may lead to time loss due to additional robot-specific tasks, such as set-up of equipment and sterile drapin
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Evaluation of time-loss in robot-assisted surgery J.P. Ruurda, I.A.M.J. Broeders Department of Surgery, University Medical Centre Utrecht, the Netherlands H.P. G04.228, P.O. Box 85500, 3508 GA, Utrecht, the Netherlands [email protected]
Abstract Robotic surgery systems were introduced recently to deal with the basic disadvantages of laparoscopic surgery. However, working with these systems may lead to time loss due to additional robot-specific tasks, such as set-up of equipment and sterile draping of the system. To evaluate loss of time in robot-assisted surgery, we compared 10 robot-assisted cholecystectomies to 10 laparoscopic procedures by the standard technique. The robotassisted procedures were performed with the 'da Vinci' robotic telemanipulation system. The total time at the operating theatre was scored and divided in a preoperative, operative and postoperative phase. These phases were further divided in smaller time frames to precisely define moments of time-loss. Although the median total operating theatre time was longer in the robotic procedures, this difference was not significant (144 versus 199 minutes, p=O, 131). The preoperative phase was the single phase to cause time-loss due to three significantly longer time frames: set-up of equipment, preparation of materials and sterile draping. In the operative phase, the trocar entry time frame was longer in robotassisted cases than in standard procedures. Additionally, postoperative theatre clearing was longer in the robot-assisted cases. In conclusion, robot-assisted surgery leads to timeloss during preparation of routine laparoscopic procedures. Key words: Robotics, laparoscopic cholecystectomy, time analysis
1. Introduction In recent years, robotic surgery systems have found their way into operating theatres in over a hundred clinics world-wide [1-5]. These systems have been developed with the objective to overcome the traditional problems of laparoscopic surgery. The robotic systems for videoscopic surgery, also named telemanipulation systems, consist of a remote workplace for the surgeon and a tables ide robotic manipulator. The remote workplace holds a computer, which exactly translates the motions of the surgeon to the robot-held instruments. These systems offer distinct advantages regarding visualisation and manipulation such as three-dimensional imaging and extra degrees of freedom (DOF) of the instruments[ 6,7] (Fig. I.). Where performing surgery with these systems offers distinct advantages to the surgeon, the use of robotics requires additional steps, mainly during the start of a procedure. The time needed for specific robot related tasks, such as system set-up and sterile draping, adds to the total burden for the operating time schedule, which is disadvantageous in routine surgery [8,9]. Therefore, the aim of this study is to evaluate this time-loss and to
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