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Quantification of Surgical Workflow during Robotic Proctectomy
AIM: Assessments of surgical workflow offer insight regarding procedure variability, case complexity and surgeon proficiency. We utilize an objective method to evaluate step-by-step workflow and step transitions during robotic proctectomy (RP). METHODS: We annotated 31 RPs using a procedure-specific...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Journal Experts
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10602135/ https://www.ncbi.nlm.nih.gov/pubmed/37886442 http://dx.doi.org/10.21203/rs.3.rs-3462719/v1 |
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author | Gillani, Mishal Rupji, Manali Devin, Courtney Purvis, Lilia Olson, Terrah Paul Jarc, Anthony Shields, Mallory Liu, Yuan Rosen, Seth |
author_facet | Gillani, Mishal Rupji, Manali Devin, Courtney Purvis, Lilia Olson, Terrah Paul Jarc, Anthony Shields, Mallory Liu, Yuan Rosen, Seth |
author_sort | Gillani, Mishal |
collection | PubMed |
description | AIM: Assessments of surgical workflow offer insight regarding procedure variability, case complexity and surgeon proficiency. We utilize an objective method to evaluate step-by-step workflow and step transitions during robotic proctectomy (RP). METHODS: We annotated 31 RPs using a procedure-specific annotation card. Using Spearman’s correlation, we measured strength of association of step time and step visit frequency with console time (CT) and total operative time (TOT). RESULTS: Across 31 RPs, a mean (± standard deviation) of 49.0 (± 20.3) steps occurred per procedure. Mean CT and TOT were 213 (± 90) and 283 (± 108) minutes. Posterior mesorectal dissection required most visits (8.7 ± 5.0), while anastomosis required most time (18.0 [± 8.5] minutes). Inferior mesenteric vein (IMV) ligation required least visits (1.0 ± 0.0) and lowest duration (0.9 [± 0.5] minutes). Strong correlations were seen with CT and step times for IMV dissection and ligation (ρ = 0.60 for both), lateral-to-medial splenic flexure mobilization (SFM) (ρ = 0.63), left rectal dissection (ρ = 0.64) and mesorectal division (ρ = 0.71). CT correlated strongly with medial-to-lateral and supracolic SFM visit frequency (ρ = 0.75 and ρ = 0.65). There were strong correlations with TOT and initial exposure time (ρ = 0.60), as well as visit frequency for medial-to-lateral (ρ = 0.67) and supracolic SFM (ρ = 0.65). Descending colon mobilization was nodal, rectal mobilization convergent and rectal transection divergent. CONCLUSION: This study correlates individual surgical steps with CT and TOT through standardized annotation. It provides an objective approach to quantify workflow. |
format | Online Article Text |
id | pubmed-10602135 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | American Journal Experts |
record_format | MEDLINE/PubMed |
spelling | pubmed-106021352023-10-27 Quantification of Surgical Workflow during Robotic Proctectomy Gillani, Mishal Rupji, Manali Devin, Courtney Purvis, Lilia Olson, Terrah Paul Jarc, Anthony Shields, Mallory Liu, Yuan Rosen, Seth Res Sq Article AIM: Assessments of surgical workflow offer insight regarding procedure variability, case complexity and surgeon proficiency. We utilize an objective method to evaluate step-by-step workflow and step transitions during robotic proctectomy (RP). METHODS: We annotated 31 RPs using a procedure-specific annotation card. Using Spearman’s correlation, we measured strength of association of step time and step visit frequency with console time (CT) and total operative time (TOT). RESULTS: Across 31 RPs, a mean (± standard deviation) of 49.0 (± 20.3) steps occurred per procedure. Mean CT and TOT were 213 (± 90) and 283 (± 108) minutes. Posterior mesorectal dissection required most visits (8.7 ± 5.0), while anastomosis required most time (18.0 [± 8.5] minutes). Inferior mesenteric vein (IMV) ligation required least visits (1.0 ± 0.0) and lowest duration (0.9 [± 0.5] minutes). Strong correlations were seen with CT and step times for IMV dissection and ligation (ρ = 0.60 for both), lateral-to-medial splenic flexure mobilization (SFM) (ρ = 0.63), left rectal dissection (ρ = 0.64) and mesorectal division (ρ = 0.71). CT correlated strongly with medial-to-lateral and supracolic SFM visit frequency (ρ = 0.75 and ρ = 0.65). There were strong correlations with TOT and initial exposure time (ρ = 0.60), as well as visit frequency for medial-to-lateral (ρ = 0.67) and supracolic SFM (ρ = 0.65). Descending colon mobilization was nodal, rectal mobilization convergent and rectal transection divergent. CONCLUSION: This study correlates individual surgical steps with CT and TOT through standardized annotation. It provides an objective approach to quantify workflow. American Journal Experts 2023-10-20 /pmc/articles/PMC10602135/ /pubmed/37886442 http://dx.doi.org/10.21203/rs.3.rs-3462719/v1 Text en https://creativecommons.org/licenses/by/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/) , which allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use. |
spellingShingle | Article Gillani, Mishal Rupji, Manali Devin, Courtney Purvis, Lilia Olson, Terrah Paul Jarc, Anthony Shields, Mallory Liu, Yuan Rosen, Seth Quantification of Surgical Workflow during Robotic Proctectomy |
title | Quantification of Surgical Workflow during Robotic Proctectomy |
title_full | Quantification of Surgical Workflow during Robotic Proctectomy |
title_fullStr | Quantification of Surgical Workflow during Robotic Proctectomy |
title_full_unstemmed | Quantification of Surgical Workflow during Robotic Proctectomy |
title_short | Quantification of Surgical Workflow during Robotic Proctectomy |
title_sort | quantification of surgical workflow during robotic proctectomy |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10602135/ https://www.ncbi.nlm.nih.gov/pubmed/37886442 http://dx.doi.org/10.21203/rs.3.rs-3462719/v1 |
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