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Related Experiment Video

Updated: Jun 12, 2026

Surgical Robot-Assisted Transanal Specimen Extraction Radical Sigmoidectomy Without an Auxiliary Abdominal Incision
07:22

Surgical Robot-Assisted Transanal Specimen Extraction Radical Sigmoidectomy Without an Auxiliary Abdominal Incision

Published on: June 13, 2025

Surgeon workload in supervised robotic colorectal surgery: a surgical task load index study.

Yasuhiro Ishiyama1, Yasumitsu Hirano2, Sohei Akuta2

  • 1Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, Japan. yishiyama1215@saitama-med.ac.jp.

Surgical Endoscopy
|June 10, 2026
PubMed
Summary

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Robot-assisted colorectal surgery (RAS) is safe for junior surgeons despite higher workload. Surgical-TLX can guide training and supervision, especially for complex cases.

Area of Science:

  • Minimally Invasive Surgery
  • Surgical Education
  • Robotics in Medicine

Background:

  • Robot-assisted colorectal surgery (RAS) adoption is increasing.
  • Surgeon workload and its determinants during supervised RAS training are not well understood.

Purpose of the Study:

  • To assess surgeon workload using Surgical-TLX during junior surgeon training in RAS.
  • To identify factors influencing workload in junior surgeons performing RAS.
  • To evaluate the safety and outcomes of RAS performed by junior surgeons under supervision.

Main Methods:

  • A single-center study combined prospective Surgical-TLX assessment with retrospective cohort analysis.
  • Junior surgeons were defined by experience (<10 primary RAS cases, <8 years post-graduation) and operated under direct supervision.
Keywords:
Colorectal cancerRobot-assisted surgerySupervisionSurgeon workloadSurgical educationSurgical-TLX

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  • Surgical-TLX workload domains, operative metrics, and patient outcomes were analyzed.

    • Main Results:

    • Junior surgeons reported higher workload in mental, temporal, task complexity, and situational awareness domains compared to experienced surgeons.
    • Advanced tumor factors (T≥3, N-positive) correlated with higher temporal workload.
    • Operative and console times were longer for junior surgeons, but blood loss, complications (Clavien-Dindo ≥2), LOS, and pathology were comparable.

    Conclusions:

    • RAS can be safely implemented for junior surgeons under structured supervision, despite increased perceived workload.
    • Surgical-TLX provides insights into cognitive burden, aiding in graded autonomy and supervision strategies.
    • These findings are particularly relevant for managing advanced colorectal tumors using RAS.