A European Survey on Non-Technical Skills in Robotic Thoracic Surgery for Lung Resections.
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Authors
Shahin G.M.M.
Verhagen M.J.
Hutteman M.
Wink J.
Stamenkovic S.A.
Durand M.
Baste J.M.
Melfi F.
Braun, J.
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Issue Date
2025
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Article
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Abstract
Objectives: In robotic surgery, interaction between team members differs from that in open surgery, which impacts the team members' tasks and responsibilities. Training for robot-assisted thoracic surgery (RATS) is primarily focused on technical skills. However, non-technical skills (NOTECHS) are equally important for safe and high-quality surgery. There is debate whether NOTECHS require adjustments to meet specific needs of RATS. The aim of this study is to evaluate how NOTECHS domains are perceived, performed, and trained in European robotic thoracic centres. Method(s): A digital exploratory survey was distributed amongst 40 robotic thoracic surgeons in 33 European centres. The survey contained 40 questions concerning the setting, team, robotic platform, operating room set-up, briefing and debriefing (B&D), and NOTECHS. Result(s): Survey response rate was 85%. A training program for RATS is offered by 38%. There is a wide variety in team composition and set-up in the operating room. The B&D checklist is essentially the same as for open surgery. A conversion protocol is available for 85% of surgeons, but 11% are not aware of its contents. Among the 4 NOTECHS domains, communication and teamwork is considered most important, followed by situational awareness. In some centres, team training in NOTECHS is either lacking (36%) or provided only once (33%). Conclusion(s): Although the importance of NOTECHS in RATS is widely recognized among European robotic surgeons, focused and structured team training in these skills is lacking. Furthermore, a conversion protocol is not always available or known. These findings offer room for improvement and encourage further research. Copyright © The Author(s) 2025. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.
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Journal
Interdisciplinary Cardiovascular and Thoracic Surgery
Volume
40