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

Background: The introduction of robotic surgery has challenged effective communication because of the separation of thesurgeon. The aim of this study was to investigate factors that may enhance or disrupt effective communication during roboticsurgery. Methods: An observational study of 32 robotic cases involving seven surgeons at Prince of Wales Private Hospitalwas conducted between February 2024 and July 2024. The primary measure were the frequency of enhancing or disruptingcommunication 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 ± 1.5for the principal investigator (PI) surgeon and 5.7 ± 3.1 for the other surgeons (P = 0.02), respectively. The mean number ofhourly 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 theoperation duration and was abolished when only the first two hours of surgery were compared. The mean number of hourlycommunication 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 varianceshowed 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 techniqueuses based on operation duration may be reflective of increased cognitive fatigue.