Robot-assisted surgery involves using remotely operated mechanical arms-bearing instruments to perform various types of surgery on humans and animals. From minor, explorative operations to major heart, lung, and even neurosurgery, robotics has changed the landscape when it comes to surgical procedures.
When a patient reports a medical problem that needs to be investigated, a diagnosis can be made using sonar, MRI, or CT scans to take electronic images of various parts of the body to determine the area and nature of the problem. These methods use sound waves, magnetic resonance imaging, and X-ray technology to detect irregularities in our bodies.
In the diagnostic process in the pelvis or abdomen, a laparoscopy or keyhole surgery can be performed wherein a small incision is made through which a camera is inserted. This enables surgeons to take pictures and remove small samples of tissue for examination.
Similarly, a bronchoscopy takes pictures of the lungs, or a CT scan-guided needle can be used to pierce the lung and remove tissue for biopsy. Many forms of minor heart surgery today take place by means of a catheter inserted through a large blood vessel, usually in the groin, and guided to the site of the operation or investigation area by means of X-ray technology.
Microscopic cameras and robotic instruments can also be inserted through the urethra for urinary tract diagnosis and repair.
Extracorporeal shock wave therapy, or lithotripsy, can be used to blast stones in the kidney or ureter without surgical intervention. The resulting stone fragments are small enough to be passed out of the system.
Educating patients, nurses, and physicians about these procedures so they understand their benefits is important. Instead of incisions that are wide enough to accommodate the surgeon’s fingers and allow for manipulation of an organ that may be in the way, robotic instruments can fit into minute crevices in the body, resulting in considerably smaller incisions. This reduces blood loss, and thus the need for blood transfusions, while minimizing the chance of wound infection. It also means a smaller dose of anesthesia is required, and in older patients or patients with severe health issues, this could make a difference when considering whether to operate.
Smaller incisions also mean less scarring and a quicker recovery time, leading to shorter hospitalization periods. Moreover, patients may be able to return to normal daily activities and exercise sooner than they would after conventional surgery.
From the surgeon’s perspective, the high-resolution 3D images of the operable area magnified on the screen improve clarity and visibility, while maneuvering minute tools enhances the surgeon’s dexterity and allows for greater precision when performing complex operations. These robots are finely tuned to pick up slight tremors in the surgeon’s hands and correct them.
The surgeon is always in complete control of the instruments and has the backup of the anesthesiologist and nursing team at the patient’s side, monitoring the patient and changing the instruments when necessary.
Typically used for intricate operations in various parts of the body, robotic methods are particularly useful in heart surgery, gynecology, and gastrointestinal procedures, as well as thoracic surgery. General surgeons use robotics for procedures such as repairs to hernias, appendectomies, and gallbladder removals.
What is the nurse’s role in robot-assisted surgery?
As more surgeons opt for robotics in their operations, nurses need to advance their skills in this area to grow in their professional careers and remain competitive in the job market. New methods mean new protocols and nurses’ functions vary in this changing environment, which means their job descriptions are becoming more diverse when seeking employment.
With these changes in the operating room environment comes a need for updated skills, new protocols, and revisions of existing best practice methods. Updated evidence-based procedures and documentation regarding patient outcomes will be based on new experience and training, as well as documented patient outcomes.
Surgeons and nurses must learn new methods of communicating with one another, aided by computer screens and electronics. Teamwork between the nurses attending to the patient takes on a different dynamic as they adjust to the new equipment and patient care procedures. Because the surgeon is facing a monitor and not at the patient’s side, the onus has fallen entirely on the nurses and anesthetists to monitor the patient and pick up any signs that indicate a potential problem.
Nurses prepare the operating room for operations, laying out the instruments and positioning the patient. According to a publication by Hospital Healthcare Europe, nurses who assist in robotic surgery may become as specialized in robotic technology as the surgeons who are performing the operation.
Once the operation is complete, the nursing team completes the patient charts, performs an inventory of robotic components, cleans the equipment, and sets everything up again for the next operation. The nurses’ role in this environment is labor-intensive and needs to be done quickly and efficiently. Therefore, attention to detail, good organizational skills, and strong teamwork are key factors in this environment.
Each nurse has a specific function in the operating room, and together they form a well-synchronized unit. The nurse coordinator, scrub nurse, and circulating nurse work together to ensure surgical efficiency and patient safety.
The nurse coordinators manage the schedule, paying careful attention to the time needed to clean and set up equipment in between operations. The computer software and operating system must be set up and ready to run for the next procedure to take place. The nurse coordinator will also be responsible for training new nurses in the team and organizing training on any new equipment that is introduced to the environment.
Scrub and circulating nurses are responsible for placing the robotic equipment on the cart. Therefore, they need to be familiar with the type of equipment needed for each surgical procedure. They also check pads, tubes, cables, consoles, and oxygen tubes to ensure everything is working. Patient safety is their main concern, and they need to be able to access additional equipment promptly when required. A checklist should be consulted before each procedure begins to make sure that nothing has been omitted.
Safety measures include testing the equipment before the operation and draping it with sterile material to avoid pre-operation contamination. When the process begins, they assist with moving the robotic arm into position. They also install and manage the camera.
While the surgery is in progress, the nurses monitor the patient’s safety levels by checking for possible pressure on the patient’s body caused by the equipment and signs of robot malfunction. They also check the console for error messages and react accordingly.
Robotic instruments have a limited lifespan, and the nurses’ duty is to keep track of how many times a piece of equipment is used, discarding it when it has reached end-of-life status. This tracking process should ideally be done using computer software that records usage and dates. The same program can be used to record malfunctioning parts and other information that may be useful when calling out technicians to service the equipment.
These nurses are familiar with the different types of surgery and how the patient should be positioned. The patient’s surrounding pressure points, muscles, and skin are protected from harm with the use of foam padding or inflationary devices, and nurses are trained in efficiently undocking the equipment should an emergency arise.
The advantages for nurses who move into the field of robotic surgery are numerous. For many, this is a less stressful method of operating as the smaller incision leads to less shedding of blood and a reduced need for blood transfusions. The lower likelihood of infection means nurses can focus on other aspects of the operation.
Qualified nurses with at least two years of experience can find out more about new technology in nursing and upgrade their qualifications at Walsh University online while still working and gaining valuable experience. It’s an exciting time to be in nursing, and the options for improving your technical skills and your value as a skilled nurse are just a click away.
Employment options and training for robotic surgery nurses
Ongoing learning in the medical profession is part of the job, and medical personnel worldwide are finding it necessary to keep up with the latest trends in technology as they are being introduced into the clinical environment.
Nurses who work with robotic machinery are required to have expert knowledge in this field. Proper cleaning and sterilization of robotic equipment is just a small part of their duties. Knowing how to operate the equipment and troubleshoot when it malfunctions is vital. Whether it is training given by the robotics supply company or in-house training, it needs to be of a high professional standard with patient safety as the main priority.
As nurses learn how, why, and when the various instruments are being used, they become an invaluable part of the surgical team as they change instruments and ensure the optimal functioning of the system.
The Severance Hospital, a world-class university hospital in South Korea, has made inroads in the field of robotic surgery, training surgeons from around the globe. As a guideline when employing robotics-skilled nurses, Severance Hospital has a strict set of requirements. They require three years of experience in an operating room setting, with multi-specialty training in an operating room that uses robotic equipment. Competency and enthusiasm help to secure a position in this environment.
Once employed, the nurses undergo a two-week training course to operate the machinery that is specific to their hospital and procedures. This includes setting up; powering the equipment on and shutting it down; knowledge of the cable connections, docking, and undocking; the position of the table and consoles; and managing errors and malfunctions. Then, nurses must attend a six-week apprenticeship course where they act as scrub nurses for at least two procedures a day. During the apprenticeship, a thorough evaluation is performed to determine the nurses’ understanding of the equipment and the procedures it is used for. A successful apprenticeship means incorporation into the operating team.
An exciting future awaits
Recent advancements in healthcare technology have been incredibly exciting. When a decision is made to operate, many patients can now choose whether to undergo the traditional method of operation or less invasive methods of surgery using lasers and robotic equipment. Some patients are still a bit wary of technology, particularly when it comes to their personal health, but in time, we may even forget that open surgery ever existed.
The costs of robotic surgery can still be an inhibiting factor, but some of the costs for patients can be offset by shorter hospital stays and a reduced need for blood transfusions, pain medication, and other incidental expenses — and the outcomes are undeniably superior.
For nurses, there is no time like the present to get involved in this fascinating field of medical technology. Becoming a robotics specialist is a great way to advance your career.
