Acquisition and Development of Scrub Nursing Skills in Robotic-Assisted Cranial and Spinal Neurosurgical Procedures

Jolanta Piszczela, Justyna Łuczyk, Barbara Byjoś, Dorota Drewniak, Jacek Szczygielski
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Abstract

Introduction. In high-tech operative specialties, including neurosurgery, the rise of interest in robotic systems is observed, since these techniques are hoped to increase the precision of the operation. However, for the optimal implementation of these solutions, the close cooperation between surgeon and perioperative nursing team as well as adequate coordination of their actions is required. These skills needs to be gained and trained. Aim. The following report describes the single center experience of the operating team in launching the robotic navigation in neurosurgical procedures from the vantage point of nursing team. Material and Methods. This work contains a phenomenological analysis of learning process and of optimalisation in cooperating the work of the involved operating team during early phase of introducing the robotic neurosurgical procedures (both cranial and spinal). Here, the typical problems during implementation of these techniques with separate analysis of single steps of preparing and applying the tool sets are described, where critical points and the potential of failure elimination is highlighted. Results. The preparing of the robotic surgical tool set is not demanding and differs only slightly from the preparation of standard sets designed for neuronavigation plus targeted cranial biopsy or percutaneous spine instrumentation, respectively. The key point is to synchronize the actions of the operating surgeon (-s), perioperative nurses and radiologic technicians. Conclusions. Implementation of robotic techniques is a challenge for the whole neurosurgical team, including the scrub/circulating nurses. What is more important in the initial phase than (usually intuitive) operation of the devices, is the coordination of single team members’ actions and developing the communication skills regarding the planned course of the surgery and potential modification of its course, needed before the surgery starts. (JNNN 2024;13(1):29–35)
机器人辅助颅脑和脊柱神经外科手术中洗刷护理技能的掌握与发展
导言。在包括神经外科在内的高科技手术专业中,人们对机器人系统的兴趣日益浓厚,因为这些技术有望提高手术的精确度。然而,要优化这些解决方案的实施,外科医生和围手术期护理团队之间必须密切合作,并充分协调他们的行动。这些技能需要学习和培训。目的以下报告从护理团队的角度介绍了单中心手术团队在神经外科手术中使用机器人导航的经验。材料与方法。在引入机器人神经外科手术(包括颅脑手术和脊柱手术)的早期阶段,这项工作包括对学习过程和参与手术团队合作工作优化的现象学分析。在此,对这些技术实施过程中的典型问题进行了描述,并对准备和应用工具集的单个步骤进行了单独分析,其中突出强调了关键点和消除故障的可能性。结果机器人手术工具套件的准备工作要求不高,与分别为神经导航加颅内靶向活检或经皮脊柱器械检查而设计的标准套件的准备工作仅有细微差别。关键在于手术外科医生、围手术期护士和放射技术人员的同步行动。结论。机器人技术的实施对包括刷手/循环护士在内的整个神经外科团队都是一项挑战。在初始阶段,比(通常是直观的)设备操作更重要的是协调团队成员的行动,以及在手术开始前培养有关手术计划进程和可能的进程修改的沟通技巧。(JNNN 2024;13(1):29-35)
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