New Technologies & NoTech Processes for Safety and Performance - Special Focus on Robotic Segmentectomies and image-assisted surgery

This practical course will help you discover the latest technological advances in robotic assisted surgery for the management of lung cancer and mediastinal lesion.

We will focus on two main aspects of the robotic-assisted surgical system platform: a technical part and a second part that will emphasize the role of human factors and the team to perform safe and efficient procedures.

Technical aspects:

• Da Vinci X surgical system, Intuitive
• 4-Arm Standardised lung resection
• Image assisted using Visible Patient® 3D reconstruction used in conjunction with TilePro (Intuitive) mode on the X system
• Firefly infrared technology
• SureForm
• Different Energy modalities
• Stapling Strategies (SureForm, Intuitive)
• Capnothorax using Airseal

Non-technical Aspects:

• Human factors
• Cognitive tools (Robotic check-list, Crisis Check-list)
• Team Training
• Stress Management
• Crisis Resource Management (CRM) using multidisciplinary team simulation
• Surgical education and prehabilitation

One of the problems of minimal invasive thoracic surgery is major intra-operative complications, especially in RATS. To address this safety concern, we started 5 years ago to develop new tools with the aim of improving operative safety and using a multidisciplinary approach.

One of the main aspects of preventing and managing major complications is based on simulation with team resource management, acute stress management and the development of non-technical skills.

This course will draw on the expertise of different specialists: an anaesthesiologist, a radiologist, a human factor expert from aviation, a psychologist, a physiotherapist, a specialist in communication and of course a thoracic surgeon.

Thoracic Surgeons

Technical Aspects - references

Chaari Z, Montagne F, …Baste JM Midterm survival of imaging-assisted robotic lung segmentectomy for non-small-cell lung cancer..Interact Cardiovasc Thorac Surg. 2021 Montagne F, Guisier F, Venissac N, Baste JM The Role of Surgery in Lung Cancer Treatment: Present Indications and Future Perspectives-State of the Art..Cancers (Basel). 2021 

For more:

• https://www.ncbi.nlm.nih.gov/pmc/?term=baste+jm+robotic
• https://www.ctsnet.org/home/jmbaste
• https://www.ircad.fr/training-center/course-calendar/?id=1054&utm_source=websurg&utm_campaign=websurg-media
• https://www.bing.com/search?q=websurg+baste+jm&cvid=3b993e602bbe46a7ba326a123633b483&FORM=ANAB01&PC=U531

Non-Technical Aspects - references

• Sarsam M, Mordojovich G, Bottet B, Baste JM Robotic development: 'patients' safety always comes first'..Interact Cardiovasc Thorac Surg. 2022
• Boujibar F, Gillibert A, Bonnevie T, …, Baste JM The 6-minute stepper test and the sit-to-stand test predict complications after major pulmonary resection via minimally invasive surgery: a prospective inception cohort study..J Physiother. 2022 

Rinieri, P., Selim, J., Le Guillou, V., & Baste, J. M. (2020). Crisis checklist (Code Red) for the management of cardiac arrest during minimally invasive thoracic surgery: case report. Journal of cardiothoracic surgery, 15(1), 173.

Jean-Marc Baste.et al Implementation of simulation-based crisis training in robotic thoracic surgery: how to improve safety and performance? JTD 2020 doi: 10.21037/jtd-2020-epts-03

• Letter From the Guest Editor: Nontechnical Skills in Cardiothoracic Surgery

Thursday June 30th 

13:00  ***Lunch***

14:00  Opening Session

14:15  General Introduction - New context in Surgical Safety and Performance in the era of Robotic Surgery

Non-Tech Skills and Tool kits for team training and working: (Human factors, crisis management, team training, Crew resource management, enhanced performances, check list, stress (JM Baste)

14:30  Operative Safety, the anaesthesiologist’s point of view (JM Selim, MM Dusseaux, A Lefèvre)

14:50  Operative Safety, the Surgeon's point of view: Cognitive simulation (3D), Cognitive tools (check lists, 3D reconstructions…), Vascular complications management (JM Baste)

15:30  Acute stress management and performance during operative complications (O Lefetz)

16:00 ***Coffee Break***

16:30  Briefing In Situ Simulation - Team Training: Objectives 

17:00  Scenario of Robotic LUL with the whole team and all the different surgical steps. Uncontrolled bleeding or major desaturation? Crisis management (JM Baste)

17:45  Debriefing: Surgeon, anaesthesiologist, consultants, participants (evaluation scale for NOTS, stress management).

18:45  End of the session

 

Friday July 1st

7:45    Opening

8:00    Robotic 4-arm technique for lung segmentectomies - Dr Ilies Bouabdallah "live" from Marseille

9:00    Presentation of pre-operative marking using virtual bronchoscopy and Radial EBUS (by videoconference in theatre) (S Lachkar)

9:30    Live Case Robotic-assisted Segmentectomy with operative planning and operative assisting using 3D model (Visible Patient)

12:00 Robotic Segementectomy Pr Pages “live” from Dijon

14:00 Live Case of Segementetcomy or standardized lobectomy: Robotic-assisted lobectomy with Da Vinci X surgical system and SureForm

16:00  Prehabilitation and RAAC protocol (F Boujibar)

16:30 Training in robotic surgery: 10 years of experience (G Mordojovich)

17:00  General debriefing focusing on the technical and non-technical parts of this course

End of course