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Related Experiment Video

Updated: Feb 18, 2026

Author Spotlight: Revolutionizing Remote Surgery with Augmented Reality and Robotics for Enhanced Precision and Accessibility
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Anticipation, teamwork and cognitive load: chasing efficiency during robot-assisted surgery.

Kevin Sexton1, Amanda Johnson1, Amanda Gotsch1

  • 1Department of Urology, ATLAS Program, Roswell Park Cancer Institute, Buffalo, New York, USA.

BMJ Quality & Safety
|July 10, 2017
PubMed
Summary

Anticipating surgical steps and team familiarity significantly improve robot-assisted surgery (RAS) efficiency. Increased anticipation reduces operating room time by 8%, while better team familiarity minimizes inconveniences, enhancing overall surgical performance.

Keywords:
Audit and feedbackCommunicationHuman factorsPerformance measuresTeamwork

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Area of Science:

  • Robotics in Medicine
  • Surgical Workflow Optimization
  • Human Factors in Surgery

Background:

  • Robot-assisted surgery (RAS) introduces new spatial and communication dynamics to the operating room.
  • Console surgeons are physically separated from the patient and surgical team.
  • The impact of team dynamics on RAS efficiency requires further investigation.

Purpose of the Study:

  • To evaluate the effect of anticipating surgical steps on RAS efficiency.
  • To assess the influence of team member familiarity on RAS performance.
  • To identify key factors impacting operative time and surgeon cognitive load in RAS.

Main Methods:

  • Analysis of video and audio recordings from 12 robot-assisted radical prostatectomies.
  • Documentation and classification of 1330 surgeon-team requests, noting anticipation levels.
  • Assessment of team familiarity and surgeon cognitive load using questionnaires (NASA-TLX).

Main Results:

  • 31% of surgical requests were anticipated, correlating with reduced operative time (8% OR time reduction).
  • Higher team familiarity was linked to fewer inconveniences during requests.
  • Anticipation, non-verbal communication, and request duration significantly correlated with surgeon cognitive load.

Conclusions:

  • Anticipation and team engagement shorten operative times in RAS.
  • Familiarity enhances team coordination and reduces operational friction.
  • Training focused on improving anticipation and team familiarity can optimize RAS efficiency.