Robot Assisted Surgery (RAS) is a new form of surgery designed to simplify minimally invasive surgery and improve surgical outcomes for the patient. Studies have demonstrated some clinical benefits for the patients and working comfort for the surgeon. However, limitations and challenges have been identified concerning both the technical and non-technical aspects. Specifically, since, with such systems, the surgeon is located on a console away from the operating table, communication and situation awareness are fundamentally affected. If the influence of RAS has largely been studied for technical and procedural aspects, fewer studies have examined its influence on non-technical aspects (i.e., teamwork, communication, leadership, situation awareness, decision making).
The aim of this article was to examine how the RAS has an influence on non-technical aspects. A systematic review, was conducted in accordance with PRISMA guidelines, aimed to review current research in RAS, specifically pertaining to the non-technical aspects. PsycInfo and Medline databases were queried for relevant articles published through 2010. Of the 617 publications identified, 43 were assessed for eligibility and 30 were finally included in the qualitative synthesis. Overall, the study of the influence of RAS on the non-technical skills is recent.
The results revealed that RAS focused mainly on urological and gynecological surgeries, and the personnel studied is the surgeon, instrumental nurses and chirurgical assistants. The methods used are mainly observation and questionnaire, and few standardized tools are used. The non-technical skills studied are relative to communication and teamwork, and fewer studies examined cognitive skills relative to decision making or situation awareness. The results of selected studies provide some recommendations (e.g., fixed team setting up, training the healthcare professionals, checklist and communication protocol) to resolve the challenges created by the RAS. Following this systematic review, research perspectives are suggested.