What is it about?
When a surgeon uses a robotic arm to perform a knee or hip replacement, the focus is usually on the robot's precision and the patient's outcome. But what about everyone else in the room? This study looked closely at how entire surgical teams, including surgeons, scrub nurses, and specialist robotic technicians, work together during robot-assisted joint replacement surgeries. Rather than observing in a lab, we analysed twelve publicly available surgical training videos, recordings created to teach surgeons how to use the Mako robotic system, to understand how collaboration unfolds in practice. While these videos naturally showcase smoother workflows rather than everyday challenges, they offered a valuable and detailed window into how experienced teams coordinate around the robot. We found that working effectively with a surgical robot is not just a technical skill; it requires teams to continuously communicate, adapt their roles, manage where they look and when, and carefully coordinate their physical positions around the robot. Based on these findings, we developed three practical strategies that surgical teams can use to work more smoothly and efficiently alongside robotic systems. These insights can help hospitals, robot designers, and surgical educators think differently about what it takes to make robotic surgery work well for everyone involved, not just the person holding the controls.
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Photo by National Cancer Institute on Unsplash
Why is it important?
What makes this work distinctive is its focus on the whole team rather than just the surgeon, a perspective that remains surprisingly rare in surgical robotics research. It is also one of the first studies to apply Socio-Technical Grounded Theory to video data in this context, offering a novel methodological approach that goes beyond simply describing what happens on screen to uncovering why and how teams adapt in real time. As robotic systems become standard equipment in operating theatres worldwide, understanding the human dynamics that surround them is increasingly urgent. This paper offers practical, actionable strategies grounded in real surgical practice, making it relevant not only to researchers but also to clinical teams, hospital administrators, and the companies designing the next generation of surgical robots.
Perspectives
This paper occupies a unique place in my doctoral journey because it sits at the boundary between preparation and immersion. At the time of this study, I had not yet set foot inside an operating theatre, and ethics approval for in-person observations was still pending. Analysing surgical training videos was both a practical solution and an unexpectedly rich experience. Watching surgeons narrate their own decision-making in real time, explaining not just what they were doing but why, gave me a level of access to expert thinking that is rarely available in research. What struck me most was how much of the complexity of surgical collaboration was visible even in videos designed to present things at their best. Even in polished training footage, you could see the spatial negotiations, the subtle role shifts, the moments where the team had to adapt around the robot's needs. That told me something important: if the complexity is this visible in the highlight reel, the reality in a live operating theatre must be even richer. This study gave me the conceptual vocabulary and the domain fluency I needed to walk into a real operating theatre with confidence. In many ways, it was my own learning curve with Makoplasty before I ever witnessed one in person. I hope readers find it useful not just as a source of findings, but as a demonstration that meaningful, human-centred insights can be generated even before you have full access to the field.
Jasper Vermeulen
Queensland University of Technology
Read the Original
This page is a summary of: Human-centred strategies for improving efficiency in Makoplasty surgeries, Behaviour and Information Technology, January 2026, Taylor & Francis,
DOI: 10.1080/0144929x.2026.2614051.
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