LBA-23 SINGLE PORT RADICAL PROSTATECTOMY VERSUS XI MULTI-PORT RADICAL PROSTATECTOMY: A HUMAN FACTOR ANALYSIS

Abstract

Introduction & Objective: The process of learning a given task can be understood through the context of cognitive load theory. Cognitive load measures the number of informational elements that need to be processed to complete a task. It has been shown that an increase in overall cognitive load can impede the process of learning, resulting in decreased efficiency and suboptimal surgeon performance. The da Vinci Single Port (SP) robotic platform (Intuitive Surgical, Sunnyvale, CA) is a novel technology which offers new capabilities to the urologic surgeon, but its impact on surgeon cognitive load and performance is unknown. To better understand the impact of this new technology, we have compared the SP and Multi-Port (MP) platforms through objective measurement of cognitive load during the crucial steps of a robotic-assisted laparoscopic prostatectomy (RALP). Methods: We prospectively compared the first 20 SP and MP RALPs performed at our academic institution, all performed by a single experienced robotic surgeon over the same period. Comparisons were made with respect to mental workload (NASA Task Load Index), surgical workload (Surgery Task Load Index), team work (Observational Teamwork Assessment for Surgery) and workflow disruptions. Statistical analysis was performed using SPSS® 24 (IBM, Armonk, NY) with p < 0.05 considered statistically significant. The mean is used to report performance metrics. Results: All 20 SP and MP RALP procedures were performed between December 2018 and June 2019 by the same surgeon. No statistically significant difference was found between the MP and SP platforms in the cognitive workload experienced by the surgeon during the performance of a RALP for the NASA Task Load Index, Surgery Task Load Index or Observational Teamwork Assessment analyses. Workflow disruptions were similar between the two cohorts. The total robotic console time on the SP was notably less than the MP. Conclusions: There was no significant difference with respect to cognitive load, human factor or workflow disruption measures between SP and MP platforms. Furthermore, operative time was decreased on the SP, suggesting that in the hands of an experienced robotic surgeon the adaptation of this technology may improve surgical efficiency. (Figure Presented).