A Solution To The Staffing Shortage In The Or For Robotic Surgery
Daniel Eiferman, *Barbara Kerr, *Paige Starkey, Bradley Needleman
Ohio State University, Columbus, OH
OBJECTIVE(S): The COVID pandemic has resulted in a national shortage of OR staff, including staff trained as first assistants in robotic surgery resulting in the need to find additional surgical assistants or the delay of surgical care for patients. We developed a program to train surgical technologists (ST) to practice at the top of their scope of practice and participate as an assistant in robotic cases which eliminated the need for an additional staff member in certain robotic cases. METHODS:
STs interested in gaining an additional skill set underwent a supervised training program to ensure competency in the following areas: Robot docking/undocking, instrument insertion and change, placement/removal of surgical items (e.g. suture), uterine and foley manipulation, and use of an Endocatch bag. After demonstrating competency, pilot cases were performed in the OR with ST participating as surgical technologist assistant. RESULTS:
A total of 6 STs completed the training program. Prior to program initiation, 840 robotic cases over a 12-month period did not have a FA. Robot docking and insertion of instruments was performed in under 5 minutes. Instrument exchange as well as insertion of mesh and suture were accomplished in less than 60 seconds. Suture removal was successful in under 30 seconds. Staff satisfaction and engagement in robotic surgery was significantly improved as well as the trainee experience as they are able to be at the console rather than serving in the assistant role. CONCLUSIONS:
Staffing shortages nationwide are challenging the health care system to provide efficient care. The advantages of robotic surgery are well documented but traditionally required additional staff (ST plus first assist) to perform. This training program allowed for STs to practice within their scope of practice and decreased the number of staff necessary to perform robotic surgery. Additionally, surgical trainees were able to operate at the console rather than at bedside thereby enhancing the educational experience. This training program can be replicated at any institution to help address the staffing shortage.
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