Team interactions in robotic-assisted surgery: a scoping review

Robotic-assisted surgery (RAS) significantly alters the operating theater team's spatial configuration, necessitating different communication strategies that subsequently affect team dynamics. Despite the growing prevalence of RAS, inconsistencies remain regarding the conceptualization and measurement of team interactions specifically in RAS in the existing literature. This scoping review aims to provide an overview of the empirical research on team interactions within RAS, identify research gaps, and propose future directions. We conducted the scoping review following updated methodological guidelines and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) reporting standards. Searches of PsycINFO, CINAHL, PubMed, Cochrane, Embase, MEDLINE, Web of Science, and Scopus databases were performed, including empirical articles published between January 2010 and October 2023 focusing on team interactions in RAS. Fifty-four empirical articles were included for analysis. Findings highlighted four major themes: teamwork and communication, non-technical skills, flow disruptions, and teaching/surgical education. Most included studies used quantitative methods and observational data. Communication was frequently studied but inconsistently defined and measured, whereas non-technical skills were more consistently defined and measured. Flow disruptions significantly impacted surgical outcomes, and studies emphasized the need for education on verbal communication strategies in RAS. This review illustrates the inconsistencies in defining and measuring team-related concepts in the literature, highlighting the need for standardized terminologies and measures. Future research should explore mediators and moderators in team interactions in RAS and integrate non-technical skills into training curricula. Such advancements could enhance surgical training, team effectiveness, patient safety, and outcomes associated with RAS.