Subjective workload in operating room team members during robotic hernia procedures

Area of Science:

• Robotic surgery
• Surgical workflow analysis
• Human factors in medicine

Background:

• The United States robotic surgery landscape has been dominated by a single platform for over 25 years.
• Introduction of new robotic systems necessitates evaluation of their impact on operating room team subjective workload.
• Understanding baseline workload is crucial for assessing adaptation to new surgical technologies.

Purpose of the Study:

• To establish baseline subjective workload measurements for operating room team members during robotic hernia repair using the DaVinci surgical robot.
• To provide reference points for evaluating team adaptation to new robotic platforms.
• To analyze role-based and complexity-related workload differences in robotic surgery.

Main Methods:

• Prospective collection of NASA-TLX surveys from surgeons, circulators, and scrub staff during robotic hernia repairs (February-December 2024).
• Analysis of baseline demographics and prior robotic experience.
• Linear mixed-effects models (LMMs) used to analyze role-based and complexity-related workload, accounting for repeated measurements.

Main Results:

• 131 surveys from 14 participants across 72 cases were analyzed.
• Circulators reported the highest overall workload (mean 30.6), followed by scrub staff (mean 25.1), and surgeons (mean 24.4).
• Surgeon workload significantly increased with case complexity (p < 0.0001), while circulator and scrub staff workload remained unaffected. Circulators reported higher effort and worse self-assessed performance compared to other team members.

Conclusions:

• This study provides role-specific benchmarks for intraoperative workload in robotic hernia surgery.
• Findings offer essential reference metrics for evaluating new robotic platforms.
• Further research is needed to optimize workload, enhancing patient safety, team efficiency, and staff well-being during adoption of new robotic systems.