Introduction: Spatial orientation of the robotic operating room (OR) has led to isolation of the surgeon from the bedside assistants, which may impair communication and lead to surgical flow disruptions. The objective of this study was to investigate the feasibility of attaching a live video stream of the patient bedside (Bedside Live), mounted via a tablet onto the da Vinci® console, to support communication and surgical flow.
Methods: 5 Robot assisted radical prostatectomies (RARP) and 4 radical cystectomies (RARC) were performed using a single camera angle bedside live stream supported by Noldus Observer® XT (Fig.1). OR members were audio-visually recorded. Surgeries were retrospectively coded for interruptions (defined as a cessation of both robotic arms, not including active cessation e.g. holding blood vessel for clipping). Interruptions were categorized based on cause (Equipment/Technology (E/T), Supervision/Training (S/T), Procedure Specific (PS), and Non-Procedural (NP)) and necessity (avoidable or unavoidable) (Table 1a). These procedures were then compared to 10 historic procedures without Bedside Live at our institution in terms of number and type of interruptions.
Results: The total operative time with Bedside Live was 1,361 minutes with 297 interruptions constituting 106 minutes (8%), of which 17% were avoidable (Table 1a). Interruptions were due to E/T (55%), S/T (20%), PS (19%), and NP (6%). Compared to historic cases without Bedside Live, avoidable interruption time decreased from 46% to 17%, especially E/T interruptions (only 1% with Bedside live compared to 12%) (Table 1c).
Conclusions: The use of Beside Live device was associated with less avoidable interruptions and improved surgical flow during RAS. Source of