Robotic Setup

Abstract

The overall setup of a surgical procedure is an important part of the effectiveness and organization of a surgery. As robotic surgery grows every day, more hernia repair procedures have been done using this technology and a standardized, well-organized setup in this area has to be drawn to make this procedure safer, feasible, and reproducible.

In this context of organization and setup, ergonomics is an important part. Many studies in fields other than medicine show its impact in performance and outcomes. In the surgical field that becomes even more important when we add the patient outcomes, efficiency, and costs. Ergonomics is the applied science of equipment and workplace design and this can have an impact not only in the operating room (OR), but also on the surgical staff and other devices such as the robot.

There are many parts of the robotic setup, but three of them can be discussed a little further: overall OR setup, patient’s preparation, and the robotic docking. The first one is focused on the preparation of the room in order to maximize the effectiveness of the procedure, reduce costs, and organize all the factors involved in the surgery. This setup has to be standardized to be always reproducible and to facilitate the work of the surgical team, each with his or her specific roles. Devices, cables, cannulas, and even the surgical staff have to respect the patient’s treatment as the center of the procedure. His preparation is the second part of the robotic setup. All patients have a preoperative preparation with all the elements to secure their safety. Inside the operation he is positioned in a way to have the best surgical performance without any injury throughout the procedure. At last the robotic docking has an important role because it impacts on the OR setup, patient’s positioning, and team roles. There are many types of dockings and the same operation can have more than one. Thus the overall setup depends on the planning of the docking to be done in each type of hernia repair and patient to be treated.

After the setup is done and the surgery occurs, the surgical team and other people responsible for the robotic program can organize specific meetings to discuss the problems and the possible solutions. This feedback is important to standardize the setup and keep it evolving after each procedure.

In summary, with a straightforward program centered in a well-organized and standardized robotic setup one can have high effectiveness, with safety and feasibility, and can keep learning and evolving with each procedure.

Glossary [15]

Ergonomics

The applied science of equipment design, as for the workplace, intended to maximize productivity by reducing operator fatigue and discomfort. Also called biotechnology, human engineering, or human factors engineering. Design factors, as for the workplace, intended to maximize productivity by minimizing operator fatigue and discomfort.

Master console

The main terminal used by the computer operator or systems programmer to command the computer. The system seamlessly translates the surgeon’s hand, wrist, and finger movements into precise, real-time movements of surgical instruments.

Patient’s cart

The patient-side cart is where the patient is positioned during surgery. It includes either three or four robotic arms that carry out the surgeon’s commands.

Robotic docking

The act of placing the robot in the surgical field and attaching it to the patient’s cannulas.