Surgeons' display reduced mental effort and workload while performing robotically assisted surgical tasks, when compared to conventional laparoscopy

Surg Endosc. 2015 Sep;29(9):2553-60. doi: 10.1007/s00464-014-3967-y. Epub 2014 Nov 27.


Background: Research has demonstrated the benefits of robotic surgery for the patient; however, research examining the benefits of robotic technology for the surgeon is limited. This study aimed to adopt validated measures of workload, mental effort, and gaze control to assess the benefits of robotic surgery for the surgeon. We predicted that the performance of surgical training tasks on a surgical robot would require lower investments of workload and mental effort, and would be accompanied by superior gaze control and better performance, when compared to conventional laparoscopy.

Methods: Thirty-two surgeons performed two trials on a ball pick-and-drop task and a rope-threading task on both robotic and laparoscopic systems. Measures of workload (the surgery task load index), mental effort (subjective: rating scale for mental effort and objective: standard deviation of beat-to-beat intervals), gaze control (using a mobile eye movement recorder), and task performance (completion time and number of errors) were recorded.

Results: As expected, surgeons performed both tasks more quickly and accurately (with fewer errors) on the robotic system. Self-reported measures of workload and mental effort were significantly lower on the robotic system compared to the laparoscopic system. Similarly, an objective cardiovascular measure of mental effort revealed lower investment of mental effort when using the robotic platform relative to the laparoscopic platform. Gaze control distinguished the robotic from the laparoscopic systems, but not in the predicted fashion, with the robotic system associated with poorer (more novice like) gaze control.

Conclusions: The findings highlight the benefits of robotic technology for surgical operators. Specifically, they suggest that tasks can be performed more proficiently, at a lower workload, and with the investment of less mental effort, this may allow surgeons greater cognitive resources for dealing with other demands such as communication, decision-making, or periods of increased complexity in the operating room.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Humans
  • Laparoscopy*
  • Male
  • Robotic Surgical Procedures*
  • Surgeons*
  • Task Performance and Analysis*
  • Workload*