Improving ergonomics for the bedside assistant in robotic colorectal surgery

Wong, Shing Wai; Ang, Zhen Hao; Crowe, Philip

doi:10.1093/jscr/rjad007

Cited by 4 publications

(2 citation statements)

References 24 publications

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“…For the console surgeon, ergonomic bene ts have been studied in terms of improved visualization, posture, and manipulation [10]. However, collisions can occur between robotic arms, stopping the surgery [11]. Hence, three of the four robotic arms are typically used, which is very stressful for the console surgeon.…”

Section: Discussionmentioning

confidence: 99%

"Pure" robot simple hysterectomy with four arms and no uterine manipulator: a retrospective, non-blind, and non-randomized, comparative study

Kawamura,

Ota,

Fujiwara

et al. 2024

Preprint

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Nearly 20 years have passed since the introduction of robotic surgery for total hysterectomy, and its development has accelerated. However, its advantages over laparoscopic and open surgeries remain unclear, especially since some its drawbacks include the requirement of skilled assistants and the effective use of the robotic arms. We developed a robotic hysterectomy technique (pure robotic simple hysterectomy [PRSH]). PRSH uses four robotic arms without interference and does not require a uterine manipulator, thereby minimizing the number of assistants. However, intraoperative use of a uterine manipulator may be necessary in some cases. We retrospectively compared the characteristics and surgical outcome of patients who underwent PRSH (113 patients) or PRSH with a uterine manipulator (58 patients). Patients in the PRSH group were significantly older and had significantly higher BMI than those in the PRSH with a uterine manipulator group (48.4 ± 6.3 versus 46.0 ± 5.5, P = 0.02 and 24.4 ± 4.3 versus 26.0 ± 4.6, P = 0.03, respectively). There were no statistically significant differences between the two subgroups in terms of type of benign disease. We additionally investigated the factors that necessitated the intraoperative use of a uterine manipulator using multivariate logistic analysis. We found that in complex cases, such as endometriosis with suspected Pouch of Douglas obliteration (PRSH versus PRSH with a uterine manipulator: 1.8% versus 25.9%, P < 0.0001) and cervical and broad ligament fibroids, it was difficult to continue with the uterine manipulator-free technique, requiring the intraoperative addition of a uterine manipulator. We suggest that in such cases, assistants should be prepared preoperatively to regulate uterine manipulation.

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Section: Discussionmentioning

confidence: 99%

"Pure" robot simple hysterectomy with four arms and no uterine manipulator: a retrospective, non-blind, and non-randomized, comparative study

Kawamura,

Ota,

Fujiwara

et al. 2024

Preprint

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“…Robotic arm clashes are common consequences of reduced surgeon situation awareness [34]. Collisions between robotic arm, bedside assistant arm and patient during RAS are common [37]. Previous experience as a bedside assistant can help robotic surgeons appreciate some of the difficulties encountered by the assistant.…”

Section: Situation Awarenessmentioning

confidence: 99%

Workflow disruptions in robot-assisted surgery

Wong,

Crowe

2023

J Robotic Surg

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Surgical flow disruptions are unexpected deviations from the natural progression which can potentially compromise the safety of the operation. Separation of the surgeon from the patient and team members is the main contributor for flow disruptions (FDs) in robot-assisted surgery (RAS). FDs have been categorised as communication, coordination, surgeon task considerations, training, equipment/ technology, external factors, instrument changes, and environmental factors. There may be an association between FDs and task error rate. Intervention to counter FDs include training, operating room adjustments, checklists, teamwork, communication improvement, ergonomics, technology, guidelines, workflow optimisation, and team briefing. Future studies should focus on identifying the significant disruptive FDs and the impact of interventions on surgical flow during RAS.

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A Review on the Form and Complexity of Human–Robot Interaction in the Evolution of Autonomous Surgery

Liu,

Wang,

Wong

et al. 2024

Advanced Intelligent Systems

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As robotics and intelligence increasingly integrate into surgery, the pivotal role of human–robot interaction (HRI) in surgical procedures and outcomes becomes evident. However, debate rages over whether increasing robot autonomy will result in less human involvement. Some scholars assert that autonomy will reduce human participation, whereas others contend it will result in more complex interactions. To reveal the role of HRI in the evolution of autonomous surgery, this review systematically explores the HRI of robotic surgery with various levels of autonomy. The HRI is examined from both robotic science and clinical practice perspectives, incorporating relevant case studies. Two key components, intention detection and situation awareness, are especially concerned with a brief description of the interfaces and control strategies they rely on. Additional insights are drawn from analogous technologies in aviation, industrial robotics, and autonomous vehicles. The analysis suggests that HRI complexity tends to increase as the robot transitions from no autonomy to conditional autonomy and is predicted to subsequently decrease with a substantial shift in the interaction form when moving toward full autonomy. It is concluded by highlighting challenges from technical and clinical perspectives and delineating research trends in this rapidly evolving field.

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Improving ergonomics for the bedside assistant in robotic colorectal surgery

Cited by 4 publications

References 24 publications

"Pure" robot simple hysterectomy with four arms and no uterine manipulator: a retrospective, non-blind, and non-randomized, comparative study

"Pure" robot simple hysterectomy with four arms and no uterine manipulator: a retrospective, non-blind, and non-randomized, comparative study

Workflow disruptions in robot-assisted surgery

A Review on the Form and Complexity of Human–Robot Interaction in the Evolution of Autonomous Surgery

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