NP Role Management Boosts Perioperative Care in Hepatobiliary and Pancreatic Surgeries Aided by Da Vinci Robot

In the evolving landscape of minimally invasive surgery, the integration of advanced robotic systems with specialized nursing management has emerged as a transformative force in optimizing perioperative outcomes for complex surgical procedures. Hepatobiliary and pancreatic surgeries have long been associated with high surgical complexity, significant perioperative risks, and prolonged recovery periods due to the intricate anatomical structure of the abdominal cavity and the critical physiological functions of the involved organs. The da Vinci surgical system, a state-of-the-art computer-assisted robotic platform, has revolutionized minimally invasive surgery with its high-definition 3D vision, seven-degree-of-freedom robotic arms, and tremor reduction technology, addressing many limitations of traditional laparoscopic and open surgeries. However, the full clinical potential of this robotic system can only be realized with a standardized, systematic, and interdisciplinary perioperative management approach that aligns with the technical characteristics of robotic surgery. Nurse Practitioner (NP) role management, a model that empowers specialized nurses to take on expanded clinical responsibilities, has become a key complement to advanced surgical technologies, bridging the gap between medical and nursing care and creating a collaborative model for physicians, nurses, and patients.

A groundbreaking clinical study has delved into the application value of NP role management in the perioperative period of hepatobiliary and pancreatic surgeries assisted by the da Vinci surgical robot, revealing that the combined management model of NP role management and robotic surgical assistance significantly improves perioperative indicators, reduces postoperative complications, alleviates patients’ negative emotions, and enhances the professional collaboration of medical and nursing teams. This research not only provides empirical evidence for the clinical application of robotic surgery in hepatobiliary and pancreatic surgery but also pioneers a new path for the innovation of nursing management models in the era of precision medicine, offering valuable insights for the development of interdisciplinary collaborative care in chronic disease management and perioperative care.

The concept of Nurse Practitioner originated in the United States in the mid-20th century and has since developed into a vital component of the global healthcare system, with NPs serving as independent healthcare providers capable of conducting clinical assessments, making diagnostic decisions, and coordinating multidisciplinary care. In China, the development of the NP system is in its exploratory stage, with the first on-the-job NP training program in chronic disease management jointly launched by Peking University and the China Medical Board (CMB) from April 2019 to April 2020, marking a pivotal step in adapting the NP model to China’s national healthcare context. As the demand for high-quality healthcare services continues to rise amid the implementation of the Healthy China strategy, the expansion of nursing roles and the improvement of nursing professionalism have become inevitable trends in the development of the healthcare industry. NPs, with their comprehensive clinical capabilities and interdisciplinary coordination skills, are well-positioned to play a crucial role in perioperative care, chronic disease management, and continuous care, especially in complex surgical fields such as hepatobiliary and pancreatic surgery where precise perioperative management is essential for improving patient outcomes.

The da Vinci surgical system, as a representative of modern robotic surgical technology, has distinct advantages over traditional surgical methods in hepatobiliary and pancreatic surgeries. Its 3D vision system can magnify the surgical field by 20 to 30 times, providing surgeons with an ultra-clear view of the intricate anatomical structures of the liver, gallbladder, pancreas, and biliary tract, enabling precise identification and dissection of blood vessels and bile ducts. The seven-degree-of-freedom robotic arms simulate the flexible movements of the human hand and eliminate surgical tremors, allowing for delicate operations such as precise suture and hemostasis in narrow surgical spaces, which is particularly important for complex procedures such as pancreaticoduodenectomy and liver segment resection. Additionally, the minimally invasive nature of robotic surgery results in smaller trocar incisions, a relatively closed surgical environment, and reduced intraoperative tissue damage, which in turn lowers the risk of surgical site infection and shortens patients’ postoperative recovery time. The system also features a remote operation function, which not only reduces the physical burden on surgeons from an ergonomic perspective but also broadens the indications for laparoscopic surgery, making minimally invasive treatment available to more patients with hepatobiliary and pancreatic diseases. Clinical studies have confirmed that robotic-assisted laparoscopic hepatectomy can shorten hospital stays and reduce postoperative complications, laying a solid foundation for the realization of enhanced recovery after surgery (ERAS) in liver surgery.

Despite these advantages, the clinical application of the da Vinci surgical system still faces several challenges. The high cost of robotic surgery remains a barrier for some patients, and the lack of force feedback in the robotic arms may increase the risk of accidental injury to delicate tissues and blood vessels during the operation, such as bleeding caused by excessive traction of the pancreas or dissection of small splenic blood vessels. More importantly, as a relatively new surgical technology in China, robotic surgery currently lacks a standardized, systematic, and modular nursing management process tailored to its perioperative characteristics. The complexity of robotic surgical equipment, the specificity of surgical position requirements, and the high demand for intraoperative coordination all place higher demands on perioperative nursing care. Conventional surgical management models, which focus on basic nursing interventions such as preoperative education, routine examinations, postoperative condition observation, and rehabilitation guidance, can no longer meet the clinical needs of robotic-assisted hepatobiliary and pancreatic surgeries. There is an urgent need to establish a specialized perioperative management model that integrates the technical characteristics of robotic surgery with advanced nursing concepts to maximize the clinical benefits of robotic surgery.

In response to these clinical needs, the research team constructed a combined surgical management model of NP role management and da Vinci robotic-assisted surgery, which redefines the perioperative nursing process for hepatobiliary and pancreatic surgeries by integrating the expanded clinical responsibilities of NPs with the precise technical advantages of the da Vinci surgical system. This model is built on the concept of ERAS and adopts a multidisciplinary collaborative approach, with NPs serving as the core link between physicians, clinical nurses, and other healthcare professionals, and conducting comprehensive, whole-process, and refined management of patients throughout the preoperative, intraoperative, and postoperative periods. The construction of this model is based on a clear division of NP responsibilities and the standardization of da Vinci robotic surgical procedures, forming a closed-loop management system that covers patient assessment, surgical coordination, postoperative care, psychological intervention, and continuous care.

The core of the combined management model is the scientific definition and implementation of NP role management, which divides NP responsibilities into five dimensions: management, medical care, patient care, nursing guidance, and multidisciplinary coordination, forming a comprehensive responsibility system that covers the entire perioperative process. In terms of management, NPs work under the leadership of the department director and head nurse, participating in the organizational and management work of the department to ensure the smooth implementation of the perioperative management process for robotic surgery. In medical care, NPs assist attending physicians in performing certain medical operations under supervision, such as central venous catheterization, tube removal, and wound dressing changes, and are responsible for the standardized training and pre-job teaching of new resident physicians in the department, as well as verifying the accuracy and rationality of medical orders, which helps to improve the efficiency of clinical medical work and reduce medical errors. In patient care, NPs conduct a comprehensive assessment of patients’ present and past medical history, assist in formulating and implementing individualized nursing plans, and participate in the development of patients’ diagnosis and treatment plans, preoperative surgical risk assessment and discussion, intraoperative coordination, and postoperative rehabilitation guidance. They also pay close attention to patients’ physical and psychological status, conduct effective communication with patients and their families in a timely manner, and formulate continuous care plans for chronic disease management, realizing whole-process patient-centered care. In nursing guidance, NPs provide clinical work guidance and nursing direction for staff nurses, train their clinical thinking ability, improve their predictive nursing and decision-making skills, and carry out evidence-based medicine and diagnosis-guided nursing research, promoting the professional development of the nursing team and the improvement of nursing quality. In multidisciplinary coordination, NPs assist in multidisciplinary diagnosis and treatment activities and assume the responsibility of supervision and communication, coordinating the work of relevant departments such as the operating room, B-ultrasound room, and nutrition department to ensure seamless cooperation between different departments throughout the perioperative period and create a good interdisciplinary collaborative environment for robotic surgery.

To ensure the effective implementation of NP role management, the research team established a specialized nursing group led by an NP, consisting of one charge nurse and one staff nurse, forming a three-person nursing team with clear division of labor and close cooperation. The NP, as the group leader, is responsible for formulating the overall perioperative nursing plan for robotic surgery and guiding the implementation of the plan; the charge nurse is responsible for collecting relevant clinical data of patients, conducting a comprehensive assessment of patients’ condition and nursing needs, and providing a data basis for the formulation of individualized nursing plans; the staff nurse is responsible for implementing the nursing plan in accordance with the holistic nursing model of responsibility system, conducting daily nursing care, condition observation, and rehabilitation guidance for patients, and feeding back the implementation effect of the nursing plan to the NP and charge nurse in a timely manner. The NP and charge nurse establish a new doctor-nurse integration cooperation model with the physician team, jointly participating in patients’ diagnosis and treatment, bedside rounds, preoperative surgical risk and surgical method discussion, and postoperative rehabilitation management. They combine patients’ medical history, physical examination results, and auxiliary examination data to formulate specialized nursing plans, establish an ERAS modular pathway based on evidence-based medicine, and pay attention to the implementation effect of patient compliance with quantitative inspection indicators, which realizes the deep integration of medical and nursing care and the whole-process participation of nursing staff in the diagnosis and treatment process.

The NP role management covers the entire perioperative process, with targeted nursing interventions formulated for the preoperative, intraoperative, and postoperative stages in accordance with the technical characteristics of da Vinci robotic surgery and the physiological and psychological characteristics of patients with hepatobiliary and pancreatic diseases. In the preoperative management stage, the core goal is to reduce patients’ preoperative anxiety, optimize their physical condition, and make adequate preoperative preparations for robotic surgery. NPs use promotional materials and images to introduce patients and their families to the advantages of robotic surgery compared with traditional open and laparoscopic surgeries, the strength of the department’s medical team, surgical methods, and the surgical experience and feelings of previous patients, helping patients to eliminate doubts and uncertainty about this new technology and alleviate preoperative anxiety. Considering the important impact of nutritional status on surgical risk and postoperative recovery, NPs conduct nutritional screening for patients using the Nutrition Risk Screening 2002 (NRS-2002) scale, and provide nutritional support for patients with a nutritional screening score of ≥3 points in accordance with the “five-step therapy for malnutrition”. For these patients, total enteral nutrition (TEN) combined with partial parenteral nutrition (PPN) is adopted during the perioperative period to optimize their nutritional status and improve their surgical tolerance. As the first assistant, NPs assist the attending physician in indwelling the internal jugular central venous catheter under B-ultrasound guidance and provide standardized central venous catheter care to reduce the risk of catheter-related complications. In addition, NPs conduct smoking cessation interventions for smoking patients and guide patients to carry out pulmonary rehabilitation exercises, including teaching patients pursed-lip breathing, abdominal breathing, balloon blowing, or quantitative respiratory resistance training, and training patients in effective cough and expectoration methods to improve their pulmonary function and reduce the risk of postoperative pulmonary complications. To prevent postoperative deep venous thrombosis (DVT), NPs conduct thrombosis risk assessment for patients using the Autar scale, and guide patients with moderate and high thrombosis risk to perform preoperative bed exercises such as ankle pump exercises, quadriceps exercises, and hug-squeezing exercises, 3 to 4 groups a day, 10 to 15 times per group, to promote lower limb blood circulation and reduce the risk of DVT.

In the intraoperative coordination stage, the core goal is to ensure the smooth progress of robotic surgery and reduce the risk of intraoperative complications. NPs enter the operating room and cooperate with the circulating nurse to verify the surgical patient’s identity and surgical time, and check that the da Vinci robotic system is in standby status to avoid medical errors caused by human factors. According to the surgical method and surgical site, NPs place the specialized surgical position for robotic surgery, which is crucial for the smooth operation of the robotic arms and the surgeon’s operation. During the operation, NPs pay close attention to the patient’s fluid management, maintain a low central venous pressure state to reduce tissue edema and facilitate anastomotic suture, which is particularly important for reducing intraoperative bleeding in hepatobiliary and pancreatic surgeries. At the same time, NPs apply foam dressings to the patient’s sacrococcygeal region and heel to reduce local pressure and lower the incidence of pressure injury caused by prolonged surgical position. The close intraoperative coordination between NPs and the surgical team ensures the efficient and safe progress of robotic surgery, giving full play to the technical advantages of the da Vinci surgical system.

In the postoperative care stage, the core goal is to closely monitor the patient’s condition, prevent postoperative complications, and promote the early recovery of patients’ physical function. NPs closely monitor the patient’s vital signs after surgery and provide routine nursing care for hepatobiliary and pancreatic surgery, including close observation of the presence of redness, swelling, heat, pain, and exudate at the surgical incision to detect signs of surgical site infection in a timely manner. They ensure the patency and fixation of drainage tubes, accurately record the nature and volume of drainage fluid, and conduct assessment, fixation, inspection, and nursing of high-risk tubes in accordance with the department’s unplanned extubation tube management plan. When performing secondary fixation of drainage tubes, the high platform method is adopted to avoid medical device-related pressure injury at the tube orifice, which effectively reduces the risk of unplanned extubation and tube-related complications. Combining the concept of ERAS, NPs strengthen the postoperative respiratory function exercise of patients to maintain their pulmonary function and reduce the risk of pulmonary complications. They also guide patients to perform simple exhaust exercises combined with Zusanli acupoint massage after surgery to stimulate intestinal peristalsis, reduce postoperative abdominal distension, and promote the early recovery of intestinal function, which is of great significance for shortening patients’ postoperative fasting time and accelerating their postoperative recovery.

The standardized operation of the da Vinci surgical system is another important component of the combined management model, with the research team formulating a standardized surgical operation process for robotic-assisted hepatobiliary and pancreatic surgeries to ensure the precision and safety of the operation. First, in the design of the patient’s surgical position, after general anesthesia, the patient is placed in a head-up and foot-down position with the long axis of the human body at a 30° angle to the horizontal plane and the lower limbs separated, and the right or left side is elevated according to the location of the lesion in the organ to fully expose the surgical field and facilitate the operation of the robotic arms. Second, in the layout of surgical trocars, a 12 mm trocar is placed 1 cm below the umbilicus to form a detection hole, and an artificial carbon dioxide (CO2) pneumoperitoneum with a pressure of 12 mmHg is established to create a sufficient surgical space for robotic surgery. The da Vinci robotic arms are pushed in from directly above the patient’s head and fixed, and the position of the 3D camera lens and five trocars is adjusted according to the organ location, lesion condition, and medical history, so that each trocar hole is distributed in an arc around the planned surgical incision with an interval of more than 5 cm, which avoids mutual interference between the robotic arms during the operation and ensures the flexibility of the robotic arms. Third, in the surgical auxiliary operation, the surgeon uses the robotic system to explore the morphological information such as the location, size, and boundary of abdominal organs and lesions, marks the planned surgical incision according to the adjacent relationship of surrounding tissues, and uses an ultrasonic scalpel to resect the lesion, coagulate and close blood vessels and bile ducts, achieve hemostasis on the surgical wound, and perform suture after confirmation of no error. A drainage tube is placed if necessary, and the surgical specimen is retrieved to complete the operation. The standardized surgical operation process ensures the precision and safety of robotic-assisted hepatobiliary and pancreatic surgeries, laying a solid foundation for improving surgical outcomes and reducing postoperative complications.

To verify the clinical application effect of the combined management model of NP role management and da Vinci robotic-assisted surgery, the research team conducted a prospective clinical controlled study in the Department of Hepatobiliary and Pancreatic Surgery of the Haikou Affiliated Hospital of Central South University Xiangya School of Medicine. A total of 40 patients with hepatobiliary and pancreatic diseases who underwent surgical treatment from May 2020 to April 2021 were selected as the research subjects, and they were randomly divided into a control group and an observation group with 20 cases in each group using a random number table method. The control group adopted the conventional surgical management model, with the surgery performed by physicians with associate senior titles or above, and basic nursing interventions including preoperative education, routine examinations, postoperative condition observation, rehabilitation nursing, and psychological counseling and medication guidance when necessary. The observation group adopted the combined management model of NP role management and da Vinci robotic-assisted surgery, with the establishment of a specialized nursing group, clear definition of NP’s management content at different stages of the surgery, and the completion of the surgery and perioperative management in accordance with the standardized surgical operation process of the da Vinci surgical system. The basic clinical data of the two groups, including gender, age, and disease type, were compared, and there was no statistically significant difference, indicating good comparability. The study was approved by the Medical Ethics Committee of the hospital, and all patients and their families signed informed consent forms, ensuring the ethical compliance of the research.

The research team set three types of observation and evaluation indicators to comprehensively compare the clinical effects of the two management models: perioperative indicators, postoperative complication indicators, and psychological intervention indicators. Perioperative indicators included five key indicators: operation time, intraoperative blood loss, postoperative exhaust time, postoperative ambulation time, and hospital stay, which reflected the surgical efficiency and postoperative recovery speed of patients. Postoperative complication indicators included the number of cases of postoperative infection, bleeding, pancreatic fistula, DVT, and blood glucose elevation, which reflected the safety of the surgery and the effectiveness of perioperative complication prevention. Psychological intervention indicators used the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) to evaluate the psychological status of patients before intervention (on the 1st day of admission) and after intervention (on the 1st day before discharge), which reflected the effect of psychological intervention on alleviating patients’ negative emotions during the perioperative period. The research team used SPSS22.0 software for statistical analysis of the research data, with measurement data expressed as mean ± standard deviation and independent sample t-test used for comparison between groups when the data conformed to the normal distribution; count data expressed as percentage and chi-square test used for comparison between groups, with P < 0.05 considered statistically significant, ensuring the scientificity and accuracy of the research results.

The research results showed that the combined management model of NP role management and da Vinci robotic-assisted surgery achieved remarkable clinical effects, with the observation group showing significant advantages over the control group in all three types of evaluation indicators. In terms of perioperative indicators, the observation group’s operation time was (5.23 ± 2.19) hours, intraoperative blood loss was (212.73 ± 274.31) ml, postoperative exhaust time was (2.94 ± 0.25) days, postoperative ambulation time was (20.45 ± 8.90) hours, and hospital stay was (13.06 ± 5.83) days. In contrast, the control group’s operation time was (7.62 ± 2.45) hours, intraoperative blood loss was (386.36 ± 310.45) ml, postoperative exhaust time was (4.55 ± 0.37) days, postoperative ambulation time was (29.94 ± 9.45) hours, and hospital stay was (18.58 ± 4.69) days. The comparison between the two groups showed that all five perioperative indicators of the observation group were significantly better than those of the control group, with statistically significant differences (t=2.104, t=2.743, t=2.111, t=2.724, t=2.332; P < 0.05). The shorter operation time and less intraoperative blood loss in the observation group indicated that the combined management model improved surgical efficiency and reduced intraoperative trauma, which was attributed to the close intraoperative coordination of NPs and the precise surgical operation of the da Vinci surgical system. The earlier postoperative exhaust time and ambulation time indicated that the combined management model effectively promoted the early recovery of patients’ intestinal function and physical activity ability, which was the result of the comprehensive application of ERAS concept in NP’s perioperative care, such as postoperative exhaust exercises and Zusanli acupoint massage. The shorter hospital stay not only reduced the medical burden of patients but also improved the bed turnover rate of the department, reflecting the high efficiency and clinical value of the combined management model.

In terms of postoperative complication indicators, the incidence of postoperative complications in the observation group was significantly lower than that in the control group, with the observation group having a total of 1 case of complication (5%) and the control group having 9 cases (45%), showing a statistically significant difference between the two groups (χ²=8.533, P < 0.05). Specifically, the observation group had 0 cases of infection, 1 case of bleeding, 0 cases of pancreatic fistula, 0 cases of DVT, and 0 cases of blood glucose elevation, with an incidence of 0%, 5%, 0%, 0%, and 0% respectively. The control group had 3 cases of infection (15%), 2 cases of bleeding (10%), 2 cases of pancreatic fistula (10%), 1 case of DVT (5%), and 1 case of blood glucose elevation (5%). The significant reduction in the incidence of postoperative complications in the observation group fully demonstrated the effectiveness of the combined management model in preventing postoperative complications. The standardized perioperative management by NPs, including preoperative nutritional support, pulmonary rehabilitation exercises, thrombosis prevention interventions, intraoperative fluid management and pressure injury prevention, and postoperative close condition observation, drainage tube care, and respiratory function exercise, effectively reduced the risk of various postoperative complications. The precise surgical operation of the da Vinci surgical system also reduced intraoperative tissue damage, laying a solid foundation for reducing postoperative complications such as infection and bleeding. Pancreatic fistula, a serious postoperative complication of pancreatic surgery, was completely avoided in the observation group, which reflected the precise dissection and suture ability of the da Vinci surgical system and the effective postoperative care of NPs, marking a significant improvement in the safety of robotic-assisted pancreatic surgery.

In terms of psychological intervention indicators, there was no statistically significant difference in the SAS and SDS scores between the two groups before intervention, indicating that the two groups of patients had similar levels of anxiety and depression at admission (P > 0.05). After intervention, the SAS and SDS scores of both groups decreased compared with those before intervention, but the observation group’s scores decreased more significantly, with statistically significant differences between the two groups (P < 0.05). Specifically, the observation group’s SAS score after intervention was (37.64 ± 2.99) points and SDS score was (38.52 ± 3.37) points, while the control group’s SAS score was (45.25 ± 3.28) points and SDS score was (48.17 ± 3.06) points (t=8.934, t=11.275; P < 0.05). The significant improvement in the psychological status of the observation group’s patients was attributed to the comprehensive psychological intervention of NPs during the perioperative period. NPs conducted effective communication with patients and their families in a timely manner, introduced the surgical process and prognosis of robotic surgery in detail, alleviated patients’ doubts and anxiety about the surgery, and paid close attention to patients’ psychological changes during the postoperative recovery period, providing targeted psychological counseling and emotional support. The early postoperative recovery and low incidence of complications in the observation group also reduced patients’ psychological pressure caused by prolonged recovery and complications, further improving their psychological status. The improvement of patients’ psychological status is not only beneficial to their postoperative physical recovery but also an important part of high-quality healthcare services, reflecting the humanistic care of the combined management model.

The remarkable clinical effects of the combined management model of NP role management and da Vinci robotic-assisted surgery are attributed to the organic integration of NP role management and advanced robotic surgical technology, which realizes the complementary advantages of nursing management and surgical technology and creates a new model of interdisciplinary collaborative care. On the one hand, the da Vinci surgical system provides technical support for improving surgical outcomes with its precise and minimally invasive surgical advantages, reducing intraoperative trauma and postoperative complications, and laying a foundation for patients’ early recovery. On the other hand, NP role management maximizes the clinical value of robotic surgery through comprehensive, whole-process, and refined perioperative management, making up for the lack of specialized nursing management in the clinical application of robotic surgery, and ensuring the smooth implementation of the surgical process and the effectiveness of postoperative rehabilitation. The close cooperation between NPs and the surgical team realizes the deep integration of medical and nursing care, changes the traditional nursing model in which nurses only passively implement medical orders, and enables nurses to actively participate in the entire diagnosis and treatment process from preoperative assessment to postoperative rehabilitation, which not only improves the efficiency of clinical diagnosis and treatment but also enhances the professional sense and self-efficacy of nursing staff.

The implementation of the combined management model also has important implications for the development of nursing profession and the innovation of medical and nursing collaboration models in China. At present, Chinese NPs do not have prescription rights, but they can still undertake important clinical roles such as patient diagnosis and treatment, bedside rounds, preoperative surgical risk and surgical method discussion, intraoperative coordination, postoperative medical order supervision, rehabilitation and communication, and follow-up monitoring and chronic disease management after discharge. This requires nursing staff to have more professional theoretical knowledge and exquisite clinical skills, which not only brings greater challenges to nursing staff but also provides more opportunities for the development of nursing profession and the promotion of new medical and nursing collaboration models. By accumulating NP management and surgical coordination experience in clinical practice, it is possible to construct a full-cycle, multi-dimensional, and whole-process management plan covering four fields: physical, social-psychological, health-related behaviors, and environment during patients’ hospitalization and after discharge based on the Omaha System and ERAS theory, which can further reduce the incidence of patient complications, improve the quality of continuous care, and promote the early recovery of patients. The combined management model also provides a valuable reference for the application of NP role management in other surgical fields and chronic disease management, laying a solid foundation for the further development and improvement of the NP system in China.

Against the backdrop of the rapid development of medical technology and the increasing pressure of hospital admission, nursing staff are playing an increasingly important role in patients’ clinical treatment and prognostic rehabilitation. The combination of NP role management and da Vinci robotic-assisted surgery is a successful exploration of the integration of advanced nursing management models and modern surgical technology, which not only improves the perioperative outcomes of patients with hepatobiliary and pancreatic diseases but also promotes the professional development of nursing staff and the improvement of the level of medical and nursing collaboration. This combined management model conforms to the development trend of precision medicine and interdisciplinary collaborative care, and is in line with the requirements of the Healthy China strategy for high-quality healthcare services.

In the future, with the further popularization of robotic surgery in clinical practice and the continuous improvement of the NP system in China, the combined management model of NP role management and robotic-assisted surgery is expected to be applied in more surgical fields, bringing more clinical benefits to patients with various surgical diseases. At the same time, it is necessary to further improve the relevant supporting policies and regulations for the NP system, clarify the professional scope, practice rights, and liability of NPs, and provide a policy guarantee for the full play of NPs’ clinical role. It is also important to strengthen the training of NP talents, establish a standardized NP training and assessment system, and improve the comprehensive clinical capabilities and interdisciplinary coordination skills of nursing staff, to meet the clinical demand for high-level NP talents. In addition, it is necessary to further conduct in-depth clinical research and follow-up investigations on the combined management model, continuously optimize the perioperative management process, and improve the clinical application effect of the model, so as to provide more scientific and effective perioperative management solutions for clinical practice and make greater contributions to the improvement of patients’ surgical outcomes and the development of the healthcare industry.

This study was conducted by Wen Wen, Zhou Shuai, Chen Yingshuang, Chen Chunhua from the Department of Hepatobiliary and Pancreatic Surgery, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, and Wang Shuhong from the Nursing Department of Xiangya Hospital of Central South University. The research results were published in the September 2021 issue (Vol.18, No.9) of China Medical Equipment, with the DOI: 10.3969/J.ISSN.1672-8270.2021.09.033.

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