Quantification of surgical workflow during robotic proctectomy

Background Surgical workflow assessments offer insight regarding procedure variability. We utilised an objective method to evaluate workflow during robotic proctectomy (RP). Methods We annotated 31 RPs and used Spearman's correlation to measure the correlation of step time and step visit frequency with console time (CT) and total operative time (TOT). Results Strong correlations were seen with CT and step times for inferior mesenteric vein dissection and ligation ( ρ = 0.60, ρ = 0.60), lateral‐to‐medial splenic flexure mobilisation (SFM) ( ρ = 0.63), left rectal dissection ( ρ = 0.64) and mesorectal division ( ρ = 0.71). CT correlated strongly with medial‐to‐lateral ( ρ = 0.75) and supracolic SFM visit frequency ( ρ = 0.65). TOT correlated strongly with initial exposure time ( ρ = 0.60), and medial‐to‐lateral ( ρ = 0.67) and supracolic SFM visit frequency ( ρ = 0.65). Conclusion This study correlates surgical steps with CT and TOT through standardised annotation, providing an objective approach to quantify workflow.