Evaluation of time-loss in robot-assisted surgery

Robotic surgery systems were introduced recently to deal with the basic disadvantages of laparoscopic surgery. However, working with these systems may lead to time loss due to additional robot-specific tasks, Such as set-up of equipment and sterile draping of the system. To evaluate loss of time in robot-assisted surgery, we compared 10 robot-assisted cholecystectomies to 10 laparoscopic procedures by the standard technique. The robot-assisted procedures were performed with the 'da Vinci' robotic telemanipulation system. The total time at the operating theatre was scored and divided in a preoperative, operative and postoperative phase. These phases were further divided in smaller time frames to precisely define moments of time-loss, Although the median total operating theatre time was longer in the robotic procedures, this difference was not significant (144 versus 199 minutes, p = 0,131). The preoperative phase was the single phase to cause time-loss due to three significantly longer time frames: set-up of equipment, preparation of materials and sterile draping. In the operative phase, the trocar entry time frame was longer in robot-assisted cases than in standard procedures. Additionally, postoperative theatre clearing was longer in the robot-assisted cases. In conclusion, robot-assisted surgery leads to timeloss during preparation of routine laparoscopic procedures.