Strukturierte Implementierung und modulares inhouse Training als zentrale Erfolgsfaktoren in der robotisch assistierten Chirurgie – Evaluation am Beispiel der kolorektalen Chirurgie

Zusammenfassung

Hintergrund Darstellung der Anwendbarkeit einer strukturierten Implementierung der robotisch assistierten Chirurgie (RAS) und Evaluation einer modularen Trainingsoperation in der Implementierungsphase im Inhouse-Mentoring.

Methoden Umsetzung eines selbstdefinierten PDCA-Implementierungszyklus (PDCA: Plan–Do–Check–Act) begleitet durch die prospektive Datenerhebung von Patientencharakteristika, OP-Zeiten, Komplikationen, Konversionsraten und postoperativen Liegezeiten einer zeitlich und inhaltlich modular definierten Trainingsoperation (robotisch assistierte Rektosigmoidresektion – RARSR).

Ergebnisse Evaluation von 100 konsekutiven Operationen verteilt auf 3 Trainees und einen Inhouse-Mentor als interne Kontrollgruppe. Darstellung einer qualitativ sicheren und erfolgreichen Implementierung mit kurzer Lernkurve der Trainingsoperation bei balancierten Patientencharakteristika.

Schlussfolgerung Eine strukturierte Implementierung ermöglicht die sichere Einführung der RAS in der Viszeralchirurgie. Modulare Trainingsoperationen können dabei die Adoption der RAS durch die Anwender unter Alltagsbedingungen erleichtern. Erstmalig demonstrieren wir dies im Inhouse-Mentoring-Ansatz.

Abstract

Objectives To demonstrate the applicability of structured implementation of robotic assisted surgery (RAS) and to evaluate a modular training procedure during the implementation phase in in-house mentoring.

Method Execution of a self-defined PDCA (PDCA: Plan–Do–Check–Act) implementation cycle accompanied by prospective data collection of patient characteristics, operation times, complications, conversion rates and postoperative length of stay of a modularly defined training operation (robotic assisted rectosigmoid resection – RARSR).

Results Evaluation of 100 consecutive cases distributed among 3 trainees and an in-house mentor as internal control group. Presentation of qualitatively safe and successful implementation with a short learning curve of the training operation with balanced patient characteristics.

Conclusions Structured implementation enables the safe introduction of RAS in visceral surgery. In this context, modular training operations can facilitate the adoption of RAS by users under everyday conditions. For the first time, we demonstrate this within an in-house mentoring approach.

Schlüsselwörter

modular - Inhouse-Mentoring - Implementierung - Roboterchirurgie - Lernkurve

Keywords

modular - inhouse mentoring - implementation - robotic surgery - Learning curve

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