ears perked for the
slightest sign some-
thing's amiss.
3. Practice role-
based, worst-
case training and
simulation. Like
any procedure, train-
ing is paramount with
robotic procedures.
You want to prepare
everybody involved
not only for the rou-
tine aspects of the case, but also for the situations that you hope
never happen.
From spontaneous system resets and malfunctions to loss of quality
video feeds and broken or burnt pieces of the robot falling into the
patient's body, make sure everyone is aware of anything and every-
thing that can go wrong — and what their role should be if it does.
Hint: Be sure staff have access to the robotic key should the arm
unexpectedly lock during the procedure.
Be aware of factors that often complicate a successful robotic pro-
cedure. Comorbidities like obesity, prior surgery and lung disease
increase the chances you'll have to convert to an open procedure.
Certain positions, such as the Trendelenburg, are difficult for obese
patients to sustain and could lead to unexpected emergent conver-
sions.
Head and neck procedures present their own unique challenges —
especially for the anesthesia providers. Reason: The OR bed is turned
D E C E M B E R 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 1 1 5
• FULL HOUSE With the precious OR real estate robots take up, space can become
a real issue during an emergency that requires extra staff — a prime reason contin-
gency planning is a must.
UCLA
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