Assist team self-efficacy, training needs, and operative outcomes in single-port robotic hepatopancreatobiliary surgery: a mixed-methods study to inform protocol development

Single-port (SP) robotic surgery imposes unique spatial and technical constraints on bedside assistance personnel; however, structured training protocols for hepatopancreatobiliary (HPB) procedures are lacking. A cross-sectional survey using a 7-item Likert self-efficacy instrument was administered to 11 operating room nurses and 19 physician assistants (PAs). Free-text responses were subjected to inductive thematic analysis. Retrospective data from 92 SP robotic HPB cases performed between august 2024 and July 2025 were analyzed. PAs were grouped according to seniority into Group 1 (≥ 5 years) and Group 2 (< 5 years). A cross-sectional survey using a 7-item Likert self-efficacy instrument was administered to 11 operating room nurses and 19 physician assistants (PAs). Free-text responses were subjected to inductive thematic analysis. Retrospective data from 92 SP robotic HPB cases performed between august 2024 and July 2025 were analyzed. PAs were grouped according to seniority into Group 1 (≥ 5 years) and Group 2 (< 5 years). Emergency response and instrument exchange were identified as key areas requiring training. A structured, six-module SP robotic HPB-assist training curriculum was proposed.