Towards Human-Robotic Collaboration: Observing Teamwork of Experienced Surgeons in Robotic-Assisted Surgery

Current robotic systems in surgery are telemanipulators, but the future will likely be more automated. Past and current developments literally put the robotic system at the center of the action, and force the surgical team to adapt to it. In addition to important advantages of robotic surgery, empirical studies identify serious disadvantages in sensory perception and team communication, leading to decreased situational awareness among the surgeon and the team. We therefore raise two interrelated questions: Which actors of a surgical team should be part of a controlled, semi-automated robotic assistance and how should the collaborative interaction between the actors (including the robot) be designed. Previous research has examined the situation awareness in robotic-assisted surgeries with bedside assistant, being either residents or specifically trained registered nurse first assistants, with advantages of one over the other. We built on this work by observing for the first time robotic-assisted surgeries with highly experienced bedside assistants, senior surgeons. We found that a senior surgeon in this role excelled once again, for example, through lively medical discussions and independent problem solving, and was more likely to give us clues about a thoughtful development of semi-autonomous, collaborative surgical robots. These new insights will form the basis for subsequent interviews in which surgical teams will reflect on their expectations of the robotic agency. Our overarching goal is then to translate the results into new user interface designs for robotic surgery through repeated cycles of participatory design workshops and expert evaluations.