Team Training and Crisis Resource Management in Robot-Assisted Thoracic Surgery

To deal with nontechnical skills (Notechs) is a matter of culture and is hard to implement in surgical training. Communication, cooperation, decision-making, leadership, and situational awareness are concepts for many and their application in surgical practice is challenging. The competency framework in cardiothoracic surgery has evolved towards wider components including Notechs as a cornerstone in surgeon training. However, knowledge of Notechs should be associated with practical sessions, using simulation as an innovative teaching tool.

In this video, the authors present their crisis resource management (CRM) program for robot-assisted thoracic surgical (RATS) procedures. The CRM simulation demonstrated allows the team to practice the successful management of major bleeding during a RATS lobectomy.

Additional Resources

  1. Arriaga AF, Bader AM, Wong JM, et al. Simulation-based trial of surgical-crisis checklists. N Engl J Med. 2013;368(3):246-253.
  2. Cerfolio RJ, Bess KM, Wei B, Minnich DJ. Incidence, results, and our current intraoperative technique to control major vascular injuries during minimally invasive robotic thoracic surgery. Ann Thorac Surg. 2016;102(2):394-399.
  3. Wang TT, Ahmed K, Patel VM, et al. A competency framework in cardiothoracic surgery for training and revalidation - an international comparison. Eur J Cardiothorac Surg. 2011;40(4):816-825.
Professor Baste is a proctor for Intuitive Surgery, Medtronic, and Johnson.