Demands of surgical teams in robotic-assisted surgery: An assessment of intraoperative workload within different surgical specialties

Jennifer Zamudio; Jeffrey Woodward; Falisha F Kanji; Jennifer T Anger; Ken Catchpole; Tara N Cohen

doi:10.1016/j.amjsurg.2023.06.010

Demands of surgical teams in robotic-assisted surgery: An assessment of intraoperative workload within different surgical specialties

Am J Surg. 2023 Sep;226(3):365-370. doi: 10.1016/j.amjsurg.2023.06.010. Epub 2023 Jun 10.

Authors

Jennifer Zamudio¹, Jeffrey Woodward², Falisha F Kanji³, Jennifer T Anger⁴, Ken Catchpole⁵, Tara N Cohen⁶

Affiliations

¹ Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA. Electronic address: [email protected].
² Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC, 29425, USA. Electronic address: [email protected].
³ Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA. Electronic address: [email protected].
⁴ Department of Urology, University of California San Diego, La Jolla, CA, 92037, USA. Electronic address: [email protected].
⁵ Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC, 29425, USA. Electronic address: [email protected].
⁶ Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA. Electronic address: [email protected].

Abstract

Background: Current approaches to assessing workload in robotic-assisted surgery (RAS) focus on surgeons and lack real-world data. Understanding how workload varies by role and specialty aids in identifying effective ways to optimize workload.

Methods: SURG-TLX surveys with six domains of workload were administered to surgical staff at three sites. Staff reported workload perceptions for each domain on a 20-point Likert scale, and aggregate scores were determined per participant.

Results: 188 questionnaires were obtained across 90 RAS procedures. Significantly higher aggregate scores were reported for gynecology (Mdn = 30.00) (p = 0.034) and urology (Mdn = 36.50) (p = 0.006) than for general (Mdn = 25.00). Surgeons reported significantly higher scores for task complexity (Mdn = 8.00) than both technicians (Mdn = 5.00) (p = 0.007), and nurses (Mdn = 5.00).

Conclusions: Staff reported significantly higher workload during urology and gynecology procedures, and experienced significant differences in domain workload by role and specialty, elucidating the need for tailored workload interventions.

Keywords: Cognitive ergonomics; NASA-TLX; Robotic-assisted surgery; Workload.

MeSH terms

Gynecology*
Humans
Robotic Surgical Procedures*
Surgeons*
Urology*
Workload

Grants and funding

R01 HS026491/HS/AHRQ HHS/United States