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Updated: Dec 14, 2025

A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique

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A methodology for Dynamic Human Reliability Analysis in Robotic Surgery.

Rossella Onofrio¹, Paolo Trucco¹

¹Department of Management, Economics and Industrial Engineering - Politecnico di Milano, Via Lambruschini, 4/b - 20156, Milan, Italy.

Applied Ergonomics

|July 18, 2020

Summary

This study introduces a proactive method for analyzing surgical safety, focusing on human factors in robotic surgery. Team dynamics significantly influence patient outcomes, highlighting the need for a systems approach to surgical error reduction.

Keywords:

Dynamic event tree (DET)HEART Healthcare Human reliability analysis (HRA)Robotic surgery

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Last Updated: Dec 14, 2025

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Published on: January 6, 2023

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Published on: May 20, 2018

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Published on: August 12, 2021

Area of Science:

Surgical Safety and Human Factors Engineering
Sociotechnical Systems Analysis in Healthcare

Background:

Modern surgery faces increased complexity due to advanced technologies, introducing new error pathways and patient outcome variability.
Existing safety approaches rely on reactive analysis (e.g., root cause analysis), necessitating proactive strategies for enhanced patient safety.

Purpose of the Study:

To propose a novel methodology for mesoergonomics analysis in surgical procedures.
To enable proactive identification of critical factors influencing surgical safety and patient outcomes.

Main Methods:

Development of a Dynamic Human Reliability Analysis (DHRA) methodology for robotic surgery.
Integration of the Human Error Assessment and Reduction Technique (HEART) with a method to account for personal and organizational factors.
Pilot application to a robot-assisted radical prostatectomy.

Main Results:

The proposed mesoergonomics analysis identified key factors impacting surgical safety.
Team-related factors were found to have the most significant impact on patient outcome variability in robot-assisted surgery.

Conclusions:

A proactive, multi-level (mesoergonomics) approach is crucial for designing safer surgical systems.
Addressing team-related factors is essential for reducing variability and improving patient outcomes in complex surgical environments.