The impact of a wireless audio system on communication in robotic-assisted laparoscopic surgery: A prospective controlled trial

English version

Autoři: Ziv Tsafrir ^aff001; Kirsten Janosek-Albright ^aff003; Joelle Aoun ^aff001; Mireya Diaz-Insua ^aff003; Abd-El-Rahman Abd-El-Barr ^aff003; Lauren Schiff ^aff001; Shobhana Talukdar ^aff001; Mani Menon ^aff003; Adnan Munkarah ^aff001; Evan Theoharis ^aff001; David Eisenstein ^aff001
Působiště autorů: Minimally Invasive Gynecologic Surgery, Women’s Health Services, Henry Ford Hospital, Detroit, Michigan ^aff001; Department of Obstetrics and Gynecology, Kaplan medical Center, Rehovot, Affiliated to the Faculty of Medicine, the Hebrew University, Jerusalem, Israel ^aff002; Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan ^aff003
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0220214

Souhrn

Background

Robotic surgery presents a challenge to effective teamwork and communication in the operating theatre (OR). Our objective was to evaluate the effect of using a wireless audio headset device on communication, efficiency and patient outcome in robotic surgery.

Methods and findings

A prospective controlled trial of team members participating in gynecologic and urologic robotic procedures between January and March 2015. In the first phase, all surgeries were performed without headsets (control), followed by the intervention phase where all team members used the wireless headsets. Noise levels were measured during both phases. After each case, all team members evaluated the quality of communication, performance, teamwork and mental load using a validated 14-point questionnaire graded on a 1–10 scale. Higher overall scores indicated better communication and efficiency. Clinical and surgical data of all patients in the study were retrieved, analyzed and correlated with the survey results. The study included 137 procedures, yielding 843 questionnaires with an overall response rate of 89% (843/943). Self-reported communication quality was better in cases where headsets were used (113.0 ± 1.6 vs. 101.4 ± 1.6; p < .001). Use of headsets reduced the percentage of time with a noise level above 70 dB at the console (8.2% ± 0.6 vs. 5.3% ± 0.6, p < .001), but had no significant effect on length of surgery nor postoperative complications.

Conclusions

The use of wireless headset devices improved quality of communication between team members and reduced the peak noise level in the robotic OR.

Klíčová slova:

Urology – Surgical and invasive medical procedures – Telecommunications – Noise reduction – Minimally invasive surgery – Laparoscopy – Robotics – Gynecologic surgery

Zdroje

1. Gawande AA, Zinner MJ, Studdert DM, Brennan TA. Analysis of errors reported by surgeons at three teaching hospitals. Surgery. 2003; 133:614–21. doi: 10.1067/msy.2003.169 12796727

2. Lingard L, Espin S, Whyte S, Regehr G, Baker G, Reznick R, et al. Communication failures in the operating room: an observational classification of recurrent types and effects. Qual Saf Health Care. 2004; 13:330–4. doi: 10.1136/qshc.2003.008425 15465935

3. Joint Commission. Sentinel event data: root causes by event type 2004–2Q 2015. Available at: http://www.jointcommission.org/assets/1/18/Root_Causes_Event_Type_2004-2Q_2015.pdf. Accessed August 26, 2015.

4. Hull L, Arora S, Aggarwal R, Darzi A, Vincent C, Sevdalis N. The impact of nontechnical skills on technical performance in surgery: a systematic review. J Am Coll Surg. 2012; 214:214–30. doi: 10.1016/j.jamcollsurg.2011.10.016 22200377

5. Communication. Merriam-Webster Collegiate Dictionary. 11th ed. Springfield, MA: Meriamm-Webster, Inc; 2003:251.

6. Webster JL, Cao CG. Lowering communication barriers in operating room technology. Hum Factors. 2006; 48:747–58. doi: 10.1518/001872006779166271 17240722

7. Nyssen A-S, Balvier A. Verbal communication as a sign of adaptation in socio-technical systems: the case of robotic surgery. Proceedings of the NDM9, 9th International Conference on Naturalistic Decision Making. London: British Computer Society; 2009:267–72.

8. Cao CGL, Taylor H. Effects of new technology on the operating room team. In: Khalid HM, Helander MG, Yeo AW, eds. Work with Computing Systems. Kuala Lumpur: Damai Sciences; 2004:309–12.

9. Kurmann A, Peter M, Tschan F, Muhlemann K, Candinas D, Beldi G. Adverse effect of noise in the operating theatre on surgical-site infection. Br J Surg. 2011; 98:1021–5. doi: 10.1002/bjs.7496 21618484

10. Engelmann CR, Neis JP, Kirschbaum C, Grote G, Ure BM. A noise-reduction program in a pediatric operation theatre is associated with surgeon's benefits and a reduced rate of complications: a prospective controlled clinical trial. Ann Surg. 2014; 259:1025–33. doi: 10.1097/SLA.0000000000000253 24394594

11. Sexton JB, Helmreich RL, Neilands TB, Rowan K, Vella K, Boydan J, et al. The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Health Serv Res. 2006; 6:44. doi: 10.1186/1472-6963-6-44 16584553

12. Watts BV, Percarpio K, West P, Mills PD. Use of the Safety Attitudes Questionnaire as a measure in patient safety improvement. J Patient Saf. 2010; 6:206–9. doi: 10.1097/pts.0b013e3181fbbe86 21500606

13. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40:373–83. doi: 10.1016/0021-9681(87)90171-8 3558716

14. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004; 240:205–13. doi: 10.1097/01.sla.0000133083.54934.ae 15273542

15. Lowrance WT, Eastham JA, Savage C, Maschino AC, Laudone VP, Christopher B, et al. Contemporary open and robotic radical prostatectomy practice patterns among urologists in the United States. J Urol. 2012; 187:2087–92. doi: 10.1016/j.juro.2012.01.061 22498227

16. Smorgick N, As-Sanie S. The benefits and challenges of robotic-assisted hysterectomy. Curr Opin Obstet Gynecol. 2014; 26:290–4. doi: 10.1097/GCO.0000000000000080 24914631

17. Anderson JE, Chang DC, Parsons JK, Talamini MA. The first national examination of outcomes and trends in robotic surgery in the United States. J Am Coll Surg. 2012; 215:107–14. doi: 10.1016/j.jamcollsurg.2012.02.005 22560318

18. Tsui C, Klein R, Garabrant M. Minimally invasive surgery: national trends in adoption and future directions for hospital strategy. Surg Endosc. 2013; 27:2253–7. doi: 10.1007/s00464-013-2973-9 23660720

19. Lee YL, Kilic GS, Phelps JY. Medicolegal review of liability risks for gynecologists stemming from lack of training in robot-assisted surgery. J Minim Invasive Gynecol. 2011; 18:512–5. doi: 10.1016/j.jmig.2011.04.002 21777841

20. Lenihan JP Jr. Navigating credentialing, privileging, and learning curves in robotics with an evidence and experienced-based approach. Clin Obstet Gynecol. 2011; 54:382–90. doi: 10.1097/GRF.0b013e31822b47e2 21857169

21. Murphy DG, Bjartell A, Ficarra V, Graefen M, Haese A, Montironi R, et al. Downsides of robot-assisted laparoscopic radical prostatectomy: limitations and complications. Eur Urol. 2010; 57:735–46. doi: 10.1016/j.eururo.2009.12.021 20036784

22. Wiegmann DA, ElBardissi AW, Dearani JA, Daly RC, Sundt TM 3rd. Disruptions in surgical flow and their relationship to surgical errors: an exploratory investigation. Surgery. 2007; 142:658–65. doi: 10.1016/j.surg.2007.07.034 17981185

23. Sengpiel E. Decibel table, SPL, loudness comparison chart. Available at: www.sengpielaudio.com/TableOfSoundPressureLevels.htm. Accessed August 26, 2015.