Enhancers and disruptors of effective communication during robot-assisted surgery: A multispecialty observation study

Abstract

Background: The introduction of robotic surgery has challenged effective communication because of the separation of the
surgeon. The aim of this study was to investigate factors that may enhance or disrupt effective communication during robotic
surgery. Methods: An observational study of 32 robotic cases involving seven surgeons at Prince of Wales Private Hospital
was conducted between February 2024 and July 2024. The primary measure were the frequency of enhancing or disrupting
communication flow influencers. Welch's two-tailed unpaired t test was used to compare the following variables: surgeon,
team familiarity, and hour-block of surgery. Results: The mean number of hourly communication enhancers was 3.7 ± 1.5
for the principal investigator (PI) surgeon and 5.7 ± 3.1 for the other surgeons (P = 0.02), respectively. The mean number of
hourly communication disrupters was 2.0 ± 1.1 for the PI surgeon and 2.3 ± 1.8 for the other surgeons (P = 0.63),
respectively. The statistically significant difference in communication enhancers between surgeons was confounded by the
operation duration and was abolished when only the first two hours of surgery were compared. The mean number of hourly
communication enhancers was 4.15 ± 1.92 for the less familiar team and 5.81 ± 3.30 for the familiar team (P = 0.09),
respectively, while the mean number of hourly communication disruptors was 2.00 ± 1.20 for the less familiar team and 2.42
± 1.95 for the familiar team (P = 0.47). With regard to the hour-block of robotic console surgery time, analysis of variance
showed statistical differences in the mean number of communication enhancers and disruptors, with P < 0.001 and P =
0.004, respectively. Conclusion: The statistically significant reduction in the number of enhancing communication technique
uses based on operation duration may be reflective of increased cognitive fatigue.