Increasing the Efficiency in the Robotic Assisted PCS (Posterior Component Separation) Surgeries by Optimising the Work Flow

Aim Increasing the efficiency in robotic pcs surgeries by optimising the surgical practice for maximal utilisation of the resource. Material and Methods 47 PCS were done between Feb 2023 to Jan 2024. Of them 37 surgeries were for r TEP RS (Robotic totally extra-peritoneal Rives Stoppa Repair) with AWR (anterior wall reconstruction) and 10 procedures were r TAR (robotic Transverses abdomens release) procedures. All surgeries were performed on the DA Vinci XI platform. The need for these measures arose due to the fact that multiple departments were competing for the same resource, i.e., the Robot! These measures taken to improve the efficiency were as follows: Pre-Operatively: All patients were admitted one day in advance. All patients had an USG marking of the linea semilunaris. Intra-Operative: The Port placements were revised. Only 3 robotic instruments were utilized. The left retro-rectus plane and the space below the arcuate lines were created before the robot was deployed with the help of the Ligasure. The midline was reconstructed by using only 15 cm sutures barbed sutures. Wherever possible, self-fixation meshes were used. Result By changing few aspects of our surgical practice, we were able to reduce the operating time of our Robotic PCS from 85 min to 46 minutes. Conclusion By optimising the resources, methods and practices, the utilisation of robots can be increased without compromising the safety of the patient.