353 Summary gical expertise in live surgeries and videos of (robot assisted) laparoscopic surgery.43 These assessment methods are currently used to assess the effectiveness of training (PACE)42 or the basic surgical skill (GEARS)43. The analysis of technical surgical skills in RAS can lead to mayor improvements of postoperative outcomes.41 However, the influence of Non-Technical Skills (NTS) such as communication, teamwork, leadership, and situational awareness on postoperative outcomes should not be forgotten. The introduction of the surgical robot has changed the traditional set-up of the operating room: no longer are scrub nurse and surgeon on opposite sides of the patient. Since for the majority of the surgery, the surgeon is in the console of the robot, direct communication with his or her team could be hampered. The loss of non-verbal communication can influence the workflow and therefore the quality of the performance, as well as patient safety during surgery. Multiple general assessment methods are designed to assess NTS for both the team as a whole44–46 and for individual members of the team.47–49 The question remains if these generic tools can accurately assess NTS in a highly specialized situation such as RAS. Two systematic reviews NTS in minimal invasive surgery.50,51 Both reviews show a lack of structure in research on NTS: different methods of NTS assessments were used separately which makes comparison of tools difficult.50,51 In chapter 7 we present a study protocol describing a prospective observational multicentre study into non-technical-skills (NTS) in both Open Radical Cystectomy (ORC) and Robot Assisted Radical Cystectomy (RARC). In this study we propose a structured approach to NTS assessment using recordings from the OR in order to be able to implement all different NTS scoring methods.44,45,49,52–54 Even though the surgery of interest in this study is the radical cystectomy, results obtained during this study can be generalized beyond radical cystectomy since the changes in OR setup and the loss of non-verbal communication are universal when making the shift from open surgery to RAS. The results of this study can be used to develop effective team-training programs specifically for the introduction of the surgical robot in relation to changes in Non-Technical Skills in order to maximize surgeon and team performance. Effective training and assessment of performance are fundamental to ensuring surgeons reach their intended goal and operate safely with maximum preservation of functions.13,28,55 The field of video review and postoperative results analysis is focused on predicting postoperative results and reducing complications.41,42,56,57 Even though multiple groups have investigated the possibility of video review it is unclear if video review has found its place in daily clinical practice. In chapter 8, the results of a sur-
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