21 Robotic-Assisted Surgery
CHAPTER LESSON PLANS & OBJECTIVES
Lesson 21.1: Robotic-Assisted Surgery Technology
- 1. Describe the components of a robotic-assisted surgical system
- 2. Compare the features of robotic-assisted surgery with standard minimally invasive surgery
- 3. Describe the movements of wristed instruments
- 4. Differentiate between open and closed surgeon consoles
- 5. Describe the patient cart and its functions
- 6. Describe the features of robotic-assisted optics and vision system
Lesson 21.2: Robotic-Assisted Surgery Techniques and Team
- 7. Differentiate between the Veress needle technique and Hasson techniques for pneumoperitoneum
- 8. Discuss the importance of robotic system room layout
- 9. Discuss the role of the surgical technologist during robotic-assisted surgery
- 10. Discuss the importance of teamwork and communication during robotic-assisted surgery
Classroom Preparation
Lesson 21.1: Robotic-Assisted Surgery Technology
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 1. Describe the components of a robotic-assisted surgical system
- 2. Compare the features of robotic-assisted surgery with standard minimally invasive surgery
- 3. Describe the movements of wristed instruments
- 4. Differentiate between open and closed surgeon consoles
- 5. Describe the patient cart and its functions
- 6. Describe the features of robotic-assisted optics and vision system
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 21.1: Robotic-Assisted Surgery Technology
STUDENT PREPARATION (1 hr)
| 1 | READ – Chapter Heading(s) • Introduction • What Is Robotic-Assisted Surgery? • Section II: Robotic Technology • Components • Surgeon Console Console Design Remote Data Display Hand Controllers Foot Controls • Bedside Unit and Instrument Arms • Optics (Vision) • Equipment or Vision Tower • Types of Robotic and Computer-Assisted Systems Versius (CMR Surgery) Da Vinci Systems (Intuitive, Inc.) Senhance (TransEnterix, Inc.) Joint Arthroplasty Systems Flex Robotic Drive and Monarch Platform (Medrobotics, Inc.) ANSWER – Textbook • Review Question 10 ANSWER – Workbook • Chapter 21 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 2 | READ – Chapter Heading(s) • Features of Robotic Systems Scaled Movement Image Registration Autonomy Similarities to Minimally Invasive Surgery ANSWER – Textbook • Review Questions 1, 3, 11, 12 ANSWER – Workbook • Chapter 21 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 3 | READ – Chapter Heading(s) • Robotic Instruments Instrument Design Types of Instruments Reprocessing Robotic Instruments Haptic Feedback Rigid Endoscope Near-Infrared Imaging ANSWER – Textbook • Review Questions 4, 5 ANSWER – Workbook • Chapter 21 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 4 | READ – Chapter Heading(s) • Surgeon Console Console Design ANSWER – Textbook • Review Question 2 ANSWER – Workbook • Chapter 21 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 5 | READ – Chapter Heading(s) • Bedside Unit and Instrument Arms ANSWER – Workbook • Chapter 21 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 6 | READ – Chapter Heading(s) • Optics (Vision) • Equipment or Vision Tower ANSWER – Textbook • Review Question 8 ANSWER – Workbook • Chapter 21 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 21.1: Robotic-Assisted Surgery Technology
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 1 | SYSTEM COMPONENTS: SLIDES 4-5 | • Introduction • What Is Robotic-Assisted Surgery? • Section II: Robotic Technology • Components • Surgeon Console Console Design Remote Data Display Hand Controllers Foot Controls • Bedside Unit and Instrument Arms • Optics (Vision) • Equipment or Vision Tower • Types of Robotic and Computer-Assisted Systems Versius (CMR Surgery) Da Vinci Systems (Intuitive, Inc.) Senhance (TransEnterix, Inc.) Joint Arthroplasty Systems Flex Robotic Drive and Monarch Platform (Medrobotics, Inc.) |
| 2 | RAS VS. MIS: SLIDES 6-8 | • Features of Robotic Systems Scaled Movement Image Registration Autonomy Similarities to Minimally Invasive Surgery |
| 3 | WRISTED INSTRUMENTS: SLIDES 9-10 | • Robotic Instruments Instrument Design Types of Instruments Reprocessing Robotic Instruments Haptic Feedback Rigid Endoscope Near-Infrared Imaging |
| 4 | SURGEON CONSOLES: SLIDE 11 | • Surgeon Console Console Design |
| 5 | PATIENT CART: SLIDE 12 | • Bedside Unit and Instrument Arms |
| 6 | OPTICS: SLIDE 13 | • Optics (Vision) • Equipment or Vision Tower |
Learning Activities (choose one or more to equal 50 min)
| 1 | INVITE (50 min) • Invite a surgeon to speak to your students, asking him or her to discuss robotic surgery and how it has changed the practice of surgery and patient outcomes. • Appropriate Settings: Traditional/online/flipped classroom |
| 2 | ANALYZE (30 min) • Analyze the robotic movements and classifications. Discuss how and why the movements are an important aspect of surgery. • Appropriate Settings: Traditional/online/flipped classroom |
| 3 | DEMONSTRATE (50 min) • Demonstrate to the class the possible methods of decontamination and reprocessing robotic instruments. • Appropriate Settings: Traditional classroom |
| 4 | DISCUSS (50 min) • The concept of “long-distance surgery” has a surgeon in one location operating on a patient at a second location. Ask the students to imagine a hypothetical situation in which such a surgery will be performed. Assuming that an appropriate remote-controlled robot is available, what types of supplies, personnel, and facilities would be required at each site? Ask students what they think about this technology. Do they foresee any problems with remote surgery? Do they see any benefits for it? Appropriate Settings: Traditional/online/flipped classroom |
| 5 | INVITE (50 min) • Invite a guest surgeon to demonstrate the process of and instruments used in robotic surgery. Appropriate Settings: Traditional/online/flipped classroom |
| 6 | DISCUSS (30 min) • Discuss the use of 3-D glasses for the surgeon to perceive a 3-dimensional image. How is the 3-D image achieved and how does that improve the surgical process? • Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
What are the similarities and differences between robotic-assisted surgery (RAS) and minimally invasive surgery (MIS)?
Discussion Guidelines: RAS evolved from the technology of MIS. It originated in the 1980s from a collaboration of government agencies interested in its application to the battlefield. As a rule, RAS systems are not autonomous, but newer systems may have autonomous features. RAS provides scaled movement, stereotactic (3-D) surgery, and other innovations that may aid in the surgical process. Both RAS and MIS use minimally invasive techniques for access to the target tissues.
Classroom Preparation
Lesson 21.2: Robotic-Assisted Surgery Techniques and Team
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 7. Differentiate between the Veress needle technique and Hasson techniques for pneumoperitoneum
- 8. Discuss the importance of robotic system room layout
- 9. Discuss the role of the surgical technologist during robotic-assisted surgery
- 10. Discuss the importance of teamwork and communication during robotic-assisted surgery
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 21.2: Robotic-Assisted Surgery Techniques and Team
STUDENT PREPARATION (1 hr)
| 7 | READ – Chapter Heading(s) • Access Initial Access Review of Pneumoperitoneum and Port Placement ANSWER – Textbook • Review Questions 6, 7 ANSWER – Workbook • Chapter 21 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 8 | READ – Chapter Heading(s) • Preparation for Surgery • Room Layout Hazards Associated with Crowding Surgeon Console Bedside Cart Equipment Tower ANSWER – Textbook • Review Question 9 ANSWER – Workbook • Chapter 21 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 9 | READ – Chapter Heading(s) • Section III: The Patient • Patient Positioning • Repositioning the Patient During Surgery • Skin Prep and Draping • Role of the Surgical Technologist in Robotic-Assisted Surgery Preoperative Preparation ANSWER – Workbook • Chapter 21 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 10 | READ – Chapter Heading(s) • Emergencies During Robotic Surgery Technical Problems Surgical Problems Problems Related to Anesthesia Conversion to an Open Case Scrubbed Surgical Technologist During Conversion • Section IV: The Robotics Team • Roles of the Surgical Team • Surgeon • Assistant Surgeon • Advance Practice Providers • Circulating Nurse • Robotics Coordinator • Communication During Robotic Surgery • Robotics Training ANSWER – Workbook • Chapter 21 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 21.2: Robotic-Assisted Surgery Techniques and Team
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 7 | ACCESS: SLIDE 15 | • Access Initial Access Review of Pneumoperitoneum and Port Placement |
| 8 | ROOM LAYOUT: SLIDE 16 | • Preparation for Surgery • Room Layout Hazards Associated with Crowding Surgeon Console Bedside Cart Equipment Tower |
| 9 | ROLE OF ST: SLIDE 17 | • Section III: The Patient • Patient Positioning • Repositioning the Patient During Surgery • Skin Prep and Draping • Role of the Surgical Technologist in Robotic-Assisted Surgery Preoperative Preparation |
| 10 | TEAMWORK AND COMMUNICATION: SLIDE 18 | • Emergencies During Robotic Surgery Technical Problems Surgical Problems Problems Related to Anesthesia Conversion to an Open Case Scrubbed Surgical Technologist During Conversion • Section IV: The Robotics Team • Roles of the Surgical Team • Surgeon • Assistant Surgeon • Advance Practice Providers • Circulating Nurse • Robotics Coordinator • Communication During Robotic Surgery • Robotics Training |
Learning Activities (choose one or more to equal 50 min)
| 7 | DISCUSS (30 min) • Discuss the process of port placement and the resources available to guide the procedure. • Appropriate Settings: Traditional/online/flipped classroom |
| 8 | DISCUSS (30 min) • Discuss the causes and effects of crowding in the OR and the hazards it can present to the patient and surgical team. Have students describe ways the ST can reduce these hazards. • Appropriate Settings: Traditional/online/flipped classroom |
| 9 | INVITE (50 min) • Ask a surgical technologist to discuss his or her experiences working with robotic surgery systems and instruments with the students. Ask the guest to describe his or her background and training and the challenges in working with robotic systems and instruments. • Appropriate Settings: Traditional/online/flipped classroom |
| 10 | ROLE PLAY (50 min) • Assign the students a particular role in the operating room for robotic surgery. Each student should role play what each team member’s role is during robotic surgery. Appropriate Settings: Traditional classroom DISCUSS (30 min) • Discuss the robotic training topics and methods, including the following questions: • What types of training are available? • Who offers this training? Appropriate Settings: Traditional classroom |
Critical Thinking Question
During a procedure, the surgeon’s hand begins to shake as she manipulates an instrument. She stops the surgery while she massages her arm. After a minute, she returns to continue the operation. Was this a reasonable action? Does this situation need to be reported?
Discussion Guidelines: Students might discuss the challenge of manipulating fine instruments for long periods, as well as the relatively common phenomenon of hand tremor. Students might note that it was appropriate for the surgeon to stop briefly rather than risk the procedure by continuing to operate while shaking. It is important to note that the scaled movement of the RAS system dampens or removes normal hand tremor. If the surgery continues normally and the surgeon does not show any signs of illness or other problems, there is no issue to be reported.
Assessments
Chapter 21: Robotic-Assisted Surgery
ASSESSMENTS BY OBJECTIVE
| 1-10 | Workbook • Chapter 21 Evolve Instructor Resources • Test Bank Create a quiz using ExamView; sort by objective. Evolve Student Resources • Mock Certification Exam • Review Questions |
| All | Elsevier Adaptive Quizzing • Chapter 21 – Graded quizzes (Mastery Levels 1, 2, and 3) |
