Design of a spatial aid for communication in robotic surgery

Robots are increasingly being incorporated into the clinical environment. In minimally invasive surgery, robots are used to hold the tools and camera at the operating table while the surgeon performs surgery at a console away from the rest of the surgical team, reducing the opportunity for face-to-face communication. As surgery is a team-oriented process in which surgeons, nurses, and anesthesiologists collaborate to achieve the common goal of delivering care to a patient, any barrier to communication can inhibit the team process required in surgery. This study examined surgeon-nurse spatial communication in a collaborative surgical task in a controlled experiment. It was hypothesized that providing a spatial communication aid would improve performance time and reduce the amount of communication needed for the task. Fifteen dyads of surgeons or novices completed a simulated organ manipulation task using a laparoscopic trainer box in two viewing conditions: aligned (0°) and rotated (90°) camera view. Subjects were divided into 3 experimental groups: control, cardinal directional aid, and grid directional aid. Results show that experts were faster than novices, and the directional aids significantly facilitated task performance. While the volume of communication was not different across the three groups, there was a shift toward a more collaborative style of communication in the cardinal directions and grid conditions. The findings suggest that spatial communication aids can improve performance and promote collaboration in the robotic operating room.