scholarly journals “Put the what, where? Cut here?!” challenges to coordinating attention in robot-assisted surgery: a microanalytic pilot study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046132
Author(s):  
Antara Satchidanand ◽  
Jeff Higginbotham ◽  
Ann Bisantz ◽  
Naif Aldhaam ◽  
Ahmed Elsayed ◽  
...  
Keyword(s):  
Pilot Study ◽  
Effective Means ◽  
Relative Timing ◽  
Robot Assisted ◽  
Functional Movement ◽  
Team Members ◽  
Environmental Support ◽  
Communicative Efficiency ◽  
Insight Into ◽  
Robot Assisted Surgery

IntroductionDuring robot-assisted surgery (RAS), changes to the operating room configuration pose challenges to communication by limiting team members’ ability to see one another or use gesture. Referencing (the act of pointing out an object or area in order to coordinate action around it), may be susceptible to miscommunication due to these constraints.ObjectivesExplore the use of microanalysis to describe and evaluate communicative efficiency in RAS through examination of referencing in surgical tasks.MethodsAll communications during ten robot-assisted pelvic surgeries (radical cystectomies and prostatectomies) were fully transcribed. Forty-six referencing events were identified within these and subjected to a process of microanalysis. Microanalysis employs detailed transcription of speech and gesture along with their relative timing/sequencing to describe and analyse interactions. A descriptive taxonomy for referencing strategies was developed with categories including references reliant exclusively on speech (anatomic terms/directional language and context dependent words (CD)); references reliant exclusively on gesture or available aspects of the environment (point/show, camera focus/movement in the visual field and functional movement); and references reliant on the integrated use of speech and gesture/environmental support (integrated communication (IC)). Frequency of utilisation and number/percent ‘miscommunication’, were collated within each category when miscommunication was defined as any reference met with incorrect or no identification of the target.ResultsIC and CD were the most frequently used strategies (45% and 26%, respectively, p≤0.01). Miscommunication was encountered in 22% of references. The use of IC resulted in the fewest miscommunications, while CD was associated with the most miscommunications (42%). Microanalysis provided insight into the causes and nature of successful referencing and miscommunication.ConclusionsIn RAS, surgeons complete referencing tasks in a variety of ways. IC may provide an effective means of referencing, while other strategies may not be adequately supported by the environment.

scholarly journals Anticipation, teamwork and cognitive load: chasing efficiency during robot-assisted surgery

2017 ◽  
Vol 27 (2) ◽  
pp. 148-154 ◽  
Author(s):  
Kevin Sexton ◽  
Amanda Johnson ◽  
Amanda Gotsch ◽  
Ahmed A Hussein ◽  
Lora Cavuoto ◽  
...  
Keyword(s):  
Cognitive Load ◽  
Operative Time ◽  
Pearson Correlation ◽  
Surgical Team ◽  
Robot Assisted ◽  
Team Members ◽  
Task Load ◽  
Video And Audio ◽  
Team Familiarity ◽  
Robot Assisted Surgery

IntroductionRobot-assisted surgery (RAS) has changed the traditional operating room (OR), occupying more space with equipment and isolating console surgeons away from the patients and their team. We aimed to evaluate how anticipation of surgical steps and familiarity between team members impacted efficiency.MethodsWe analysed recordings (video and audio) of 12 robot-assisted radical prostatectomies. Any requests between surgeon and the team members were documented and classified by personnel, equipment type, mode of communication, level of inconvenience in fulfilling the request and anticipation. Surgical team members completed questionnaires assessing team familiarity and cognitive load (National Aeronautics and Space Administration – Task Load Index). Predictors of team efficiency were assessed using Pearson correlation and stepwise linear regression.Results1330 requests were documented, of which 413 (31%) were anticipated. Anticipation correlated negatively with operative time, resulting in overall 8% reduction of OR time. Team familiarity negatively correlated with inconveniences. Anticipation ratio, per cent of requests that were non-verbal and total request duration were significantly correlated with the console surgeons’ cognitive load (r=0.77, p=0.006; r=0.63, p=0.04; and r=0.70, p=0.02, respectively).ConclusionsAnticipation and active engagement by the surgical team resulted in shorter operative time, and higher familiarity scores were associated with fewer inconveniences. Less anticipation and non-verbal requests were also associated with lower cognitive load for the console surgeon. Training efforts to increase anticipation and team familiarity can improve team efficiency during RAS.

scholarly journals Factors supporting and constraining the implementation of robot-assisted surgery: a realist interview study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e028635 ◽  
Author(s):  
Rebecca Randell ◽  
Stephanie Honey ◽  
Natasha Alvarado ◽  
Joanne Greenhalgh ◽  
Jon Hindmarsh ◽  
...  
Keyword(s):  
Interview Study ◽  
Routine Practice ◽  
Team Leaders ◽  
Robot Assisted ◽  
Team Members ◽  
Initial Decision ◽  
Surgical Trainees ◽  
Theatre Staff ◽  
Operation Duration ◽  
Robot Assisted Surgery

ObjectiveTo capture stakeholders’ theories concerning how and in what contexts robot-assisted surgery becomes integrated into routine practice.DesignA literature review provided tentative theories that were revised through a realist interview study. Literature-based theories were presented to the interviewees, who were asked to describe to what extent and in what ways those theories reflected their experience. Analysis focused on identifying mechanisms through which robot-assisted surgery becomes integrated into practice and contexts in which those mechanisms are triggered.SettingNine hospitals in England where robot-assisted surgery is used for colorectal operations.ParticipantsForty-four theatre staff with experience of robot-assisted colorectal surgery, including surgeons, surgical trainees, theatre nurses, operating department practitioners and anaesthetists.ResultsInterviewees emphasised the importance of support from hospital management, team leaders and surgical colleagues. Training together as a team was seen as beneficial, increasing trust in each other’s knowledge and supporting team bonding, in turn leading to improved teamwork. When first introducing robot-assisted surgery, it is beneficial to have a handpicked dedicated robotic team who are able to quickly gain experience and confidence. A suitably sized operating theatre can reduce operation duration and the risk of de-sterilisation. Motivation among team members to persist with robot-assisted surgery can be achieved without involvement in the initial decision to purchase a robot, but training that enables team members to feel confident as they take on the new tasks is essential.ConclusionsWe captured accounts of how robot-assisted surgery has been introduced into a range of hospitals. Using a realist approach, we were also able to capture perceptions of the factors that support and constrain the integration of robot-assisted surgery into routine practice. We have translated these into recommendations that can inform future implementations of robot-assisted surgery.

scholarly journals Haptic Robot-assisted Surgery Improves Accuracy of Wide Resection of Bone Tumors: A Pilot Study

2013 ◽  
Vol 471 (3) ◽  
pp. 851-859 ◽  
Author(s):  
Fazel Khan ◽  
Andrew Pearle ◽  
Christopher Lightcap ◽  
Patrick J. Boland ◽  
John H. Healey
Keyword(s):  
Pilot Study ◽  
Bone Tumors ◽  
Wide Resection ◽  
Robot Assisted ◽  
Robot Assisted Surgery

Proficiency-based training of medical students using virtual simulators for laparoscopy and robot-assisted surgery: results of a pilot study

2018 ◽  
Vol 70 (3) ◽  
pp. 401-405 ◽  
Author(s):  
Andrea Moglia ◽  
Sara Sinceri ◽  
Vincenzo Ferrari ◽  
Mauro Ferrari ◽  
Franco Mosca ◽  
...  
Keyword(s):  
Medical Students ◽  
Pilot Study ◽  
Robot Assisted ◽  
Robot Assisted Surgery

A Pilot Study of Mobile Telephone Message Interventions with Suicide Attempters in China

Crisis ◽  
2010 ◽  
Vol 31 (2) ◽  
pp. 109-112 ◽  
Author(s):  
Hui Chen ◽  
Brian L. Mishara ◽  
Xiao Xian Liu
Keyword(s):  
Pilot Study ◽  
Effective Means ◽  
Text Message ◽  
Text Messages ◽  
Mobile Telephone ◽  
Future Research ◽  
Quick Method ◽  
Suicide Attempters ◽  
To Receive

Background: In China, where follow-up with hospitalized attempters is generally lacking, there is a great need for inexpensive and effective means of maintaining contact and decreasing recidivism. Aims: Our objective was to test whether mobile telephone message contacts after discharge would be feasible and acceptable to suicide attempters in China. Methods: Fifteen participants were recruited from suicide attempters seen in the Emergency Department in Wuhan, China, to participate in a pilot study to receive mobile telephone messages after discharge. All participants have access to a mobile telephone, and there is no charge for the user to receive text messages. Results: Most participants (12) considered the text message contacts an acceptable and useful form of help and would like to continue to receive them for a longer period of time. Conclusions: This suggests that, as a low-cost and quick method of intervention in areas where more intensive follow-up is not practical or available, telephone messages contacts are accessible, feasible, and acceptable to suicide attempters. We hope that this will inspire future research on regular and long-term message interventions to prevent recidivism in suicide attempters.

Do People Trust in Robot-Assisted Surgery? Evidence from Europe (Preprint)

2020 ◽  
Author(s):  
Joan Torrent-Sellens ◽  
Ana Jiménez-Zarco ◽  
Francesc Saigí-Rubió
Keyword(s):  
Technology Acceptance ◽  
Surgical Intervention ◽  
Negative Relationship ◽  
Predictor Variable ◽  
Major Change ◽  
Ease Of Use ◽  
The European Union ◽  
Robot Assisted ◽  
Surgical Interventions ◽  
Robot Assisted Surgery

BACKGROUND Increasingly intelligent and autonomous robots are destined to have a huge impact on our society. Their adoption, however, represents a major change to the healthcare sector’s traditional practices, which, in turn, poses certain challenges. To what extent is it possible to foresee a near-future scenario in which minor routine surgery is directed by robots? And what are the patients’ or general public’s perceptions of having surgical procedures performed on them by robots, be it totally or partially? A patient’s trust in robots and AI may facilitate the spread and use of such technologies. OBJECTIVE The goal of our study was to establish the factors that influence how people feel about having a medical operation performed on them by a robot. METHODS We used data from a 2017 Flash Eurobarometer (number 460) of European Commission with 27,901 citizens aged 15 years and over in the 28 countries of the European Union. The research designs and tests a technology acceptance model (TAM). Logistic regression (odds ratios, OR) to model the predictors of trust in robot-assisted surgery was calculated through motivational factors, robots using experience and sociodemographic independent variables. RESULTS The negative relationship between most of the predictors of ease of use, expected benefits and attitude towards robots, and confidence in robot-assisted surgery was contrasted. The only non-sociodemographic predictor variable that has a positive relationship with trust in robots participating in a surgical intervention is previous experience in the use of robots. In this context, we analyze the confidence predictors for three different levels of robot use experience (zero use, average use, and high use). The results obtained indicate that, as the experience of using robots increases, the predictive coefficients related to information, attitude and perception of robots become more negative. Research results also determined that variables of a sociodemographic nature played an important predictive role. It was confirmed that the effect of experience on trust in robots for surgical interventions was greater among men, people between 40 and 54 years old, and those with higher educational levels. CONCLUSIONS Despite the considerable benefits for the patient that the use of robots can bring in a surgical intervention, the results obtained show that trust in robots goes beyond rational decision-making. By contrasting the reasons that generate trust and mistrust in robots, especially by highlighting the experience of use as a key element, the research makes a new contribution to the state of the art and draws practical implications of the use of robots for health policy and practice.

scholarly journals Telemanipulation of an Articulated Robotic Arm using a Commercial Virtual Reality Controller

2020 ◽  
Vol 6 (3) ◽  
pp. 127-130
Author(s):  
Max B. Schäfer ◽  
Kent W. Stewart ◽  
Nico Lösch ◽  
Peter P. Pott
Keyword(s):  
Virtual Reality ◽  
Real Time ◽  
Robotic Arm ◽  
Input Device ◽  
Robot Assisted ◽  
Promising Alternative ◽  
Input Devices ◽  
Current Input ◽  
Current Systems ◽  
Robot Assisted Surgery

AbstractAccess to systems for robot-assisted surgery is limited due to high costs. To enable widespread use, numerous issues have to be addressed to improve and/or simplify their components. Current systems commonly use universal linkage-based input devices, and only a few applicationoriented and specialized designs are used. A versatile virtual reality controller is proposed as an alternative input device for the control of a seven degree of freedom articulated robotic arm. The real-time capabilities of the setup, replicating a system for robot-assisted teleoperated surgery, are investigated to assess suitability. Image-based assessment showed a considerable system latency of 81.7 ± 27.7 ms. However, due to its versatility, the virtual reality controller is a promising alternative to current input devices for research around medical telemanipulation systems.

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