CRISIS RESOURCE MANAGEMENT IN ROBOTIC THORACIC SURGERY
Gaetano Romano1, Fabrizia Calabṛ2, Carmelina Cristina Zirafa1, Claudia Cariello3, Alda Mazzei3, Selene Tognarelli4, Beatrice Manfredini5, Federico Davini1, Franca Melfi1.
1Minimally Invasive and Robotic Thoracic Surgery, University of Pisa, Pisa, Italy, 2Department of Surgical, Medical, Molecular and Critical Care Pathology, University of Pisa, Pisa, Italy, 3Department of Anesthesia and Critical Care Medicine, University Hospital of Pisa, Pisa, Italy, 4The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa., Pisa, Italy, 5Division of thoracic surgery, department of medical and surgical sciences, University of Modena and Reggio Emilia, Modena, Italy, Modena, Italy.
BACKGROUND: Robotic surgery represents the ultimate evolution of minimally invasive surgery. In high-volume centers it is mandatory to set an adequate training program for robotic surgery which also include the management of intraoperative adverse events. The objective of this video is to illustrate the simulation of the management of arterial bleeding during robotic major lung resection.
METHODS: A robotic operating room was set up asking all professionals to participate. The figures involved were: console surgeon, assistant surgeon, nurse, assistant nurse, anesthetist, assistant anesthetist.
The operating table was set up with a high-fidelity physical model integrated with an animal lung and a balloon filled with colored water to simulate bleeding.RESULTS: As bleeding occurred, the console surgeon kept the "bleeding vessel" closed with the robotic instrument, allowing the assistant and nurse to begin undocking and simulate thoracotomy.
Afterwards the first surgeon moved to the operating table for completion of surgery.CONCLUSIONS: The project proved to be effective in training the team for the adverse event, especially in the debriefing phase, during which each professional identified their tasks and any errors.
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