Robotic intracorporeal anastomosis enhances technical precision while reducing surgeon cognitive load: a prospective...

Area of Science:

• Minimally Invasive Surgery
• Surgical Robotics
• Bariatric Surgery

Background:

• Robotic surgical platforms offer potential benefits in dexterity and ergonomics.
• The impact of robotic systems on surgical technical precision and surgeon cognitive workload (CWL) requires further definition.
• This study investigates robotic versus laparoscopic gastrojejunal (GJ) anastomosis in gastric bypass.

Purpose of the Study:

• To compare the technical precision of robotic versus laparoscopic GJ anastomosis.
• To evaluate the differences in surgeon cognitive workload (CWL) between robotic and laparoscopic platforms.
• To assess the impact of robotic assistance on performance during complex revisional procedures.

Main Methods:

• A prospective, multicentre observational study involving experienced bariatric surgeons.
• Standardized GJ anastomoses performed using either robotic or laparoscopic platforms.
• Objective performance assessed via validated tools (BOSATS, GOALS, GEARS) and precision metrics; CWL measured using NASA-TLX.

Main Results:

• Global objective performance scores were comparable between robotic and laparoscopic groups.
• Robotic assistance significantly reduced surgeon frustration and overall NASA-TLX scores, particularly in complex revisional cases.
• Robotic approach showed enhanced task-specific precision, with fewer suture errors and missed knot throws; it neutralized the correlation between CWL and performance.

Conclusions:

• Robotic GJ anastomosis demonstrates superior task-specific precision and a significant reduction in CWL.
• The robotic platform acts as a performance stabilizer, particularly beneficial in complex reconstructive tasks.
• Robotic surgery offers a clinically meaningful improvement in surgeon experience and technical outcomes during demanding procedures.