title: Evaluation and Impact of Workflow Interruptions During Robot-assisted Surgery.
abstract: OBJECTIVE
  To analyze and categorize causes for interruptions during robot-assisted surgery.
  
  
  METHODS
  We analyzed 10 robot-assisted prostatectomies that were performed by 3 surgeons from October 2014 to June 2015. Interruptions to surgery were defined in terms of duration, stage of surgery, personnel involved, reasons, and impact of the interruption on the surgical workflow.
  
  
  RESULTS
  The main reasons for interruptions included the following: console surgeons switching (29%); preparation of the surgical equipment, such as cleaning or changing the camera (29%) or an instrument (27%); or when a suture, stapler, or clip was needed (12%). The most common interruption duration was 10-29 seconds (47.6%), and the least common interruption duration was greater than 90 seconds (3.6%). Additionally, about 14% of the interruptions were considered avoidable, whereas the remaining 86% of interruptions were necessary for surgery.
  
  
  CONCLUSIONS
  By identifying and analyzing interruptions, we can develop evidence-based strategies to improve operating room efficiency, lower costs, and advance patient safety.
authors.affiliation: Applied Technology Laboratory for Advanced Surgery (ATLAS), Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: Jenna C
authors.initials: JC
authors.lastname: Allers
authors.affiliation: Applied Technology Laboratory for Advanced Surgery (ATLAS), Roswell Park Cancer Institute, Buffalo, NY; Department of Urology, Cairo University, Giza, Egypt.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Hussein
authors.affiliation: Applied Technology Laboratory for Advanced Surgery (ATLAS), Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: Nabeeha
authors.initials: N
authors.lastname: Ahmad
authors.affiliation: Industrial and Systems Engineering, University at Buffalo, Buffalo, NY.
authors.forename: Lora
authors.initials: L
authors.lastname: Cavuoto
authors.affiliation: Applied Technology Laboratory for Advanced Surgery (ATLAS), Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Wing
authors.affiliation: Applied Technology Laboratory for Advanced Surgery (ATLAS), Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: Robin M
authors.initials: RM
authors.lastname: Hayes
authors.affiliation: University of Kobe, Kobe, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hinata
authors.affiliation: Industrial and Systems Engineering, University at Buffalo, Buffalo, NY.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Bisantz
authors.affiliation: Applied Technology Laboratory for Advanced Surgery (ATLAS), Roswell Park Cancer Institute, Buffalo, NY. Electronic address: Khurshid.guru@roswellpark.org.
authors.forename: Khurshid A
authors.initials: KA
authors.lastname: Guru
mesh_terms: D006801:Humans; D008297:Male; D011468:Prostatectomy / Q000379:methods*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D057188:Workflow