达芬奇机器人辅助胸腔镜肺部手术护理配合中常见机器人设备相关问题的回顾性分析

Retrospective analysis on the common problems in nursing cooperation of Da Vinci robot-assisted thoracoscopic pulmonary surgery

目的:分析上海交通大学附属胸科医院肺部肿瘤临床医学中心1 000例达芬奇机器人辅助胸腔镜(RATS)肺部手术中机器人设备的使用记录和后台报错的情况,提出相应的处理方法,为后续机器人手术的顺利开展提供保障。方法:回顾总结分析上海交通大学附属胸科医院肺部肿瘤临床医学中心2009年5月~2018年6月行RATS肺部手术护理配合过程中机器人系统相关的故障情况。结果:1 000例RATS肺部手术中共出现52次常见故障。在问题发生过程中,前期通过公司的跟台现场解决、中后期通过电话沟通指导解决及组内12名专职护士自行处理解决,均未对患者造成影响。结论:正确掌握故障的发生情况、发生类型及处理方法,可大大避免因手术器械、仪器设备操作不当致使机器人系统不能正常平稳使用、延误手术时机、增加手术风险等问题,最终减少手术中的失误,降低对患者的损伤,保障手术的顺利进行。

Objective:To summarize and analyze the operating records and backstage error reports of 1000 cases of Da Vinci robot-assisted thoracoscopic surgery(RATS)at Shanghai Lung Tumor Clinical Medical Center and propose solutions to ensure proper running in following robot-assisted surgeries.Methods:Malfunctions occurred in nursing cooperation under RATS at Shanghai Lung Tumor Clinical Medical Center from May 2009 to June 2018 were retrospectively analyzed.Results:52 common malfunctions were found in 1000 cases of RATS.The malfunctions in the early stage were solved by onsite technical support,while the problems found in the middle and late stage were communicated and guided with telephone and solved by 12 specialized nurses on site.No patients were affected by these malfunctions.Conclusion:Knowing the causes,types and solutions of malfunctions correctly can reduce the surgical risks caused by robot system errors due to improper operations of the surgical instruments,apparatus and equipment and avoid unexpected hurting to patients,which can also increase the achievement ratio of operation.