ViRAS: Design Artifacts to Explore Socio-Material Configurations through a Research-through-Design Approach in Robot-Assisted Surgery

Paper Title

ViRAS: Design Artifacts to Explore Socio-Material Configurations through a Research-through-Design Approach in Robot-Assisted Surgery

Publication Info

• Topic area: Socio-material configurations in robot-assisted surgery (RAS) using design artifacts.
• Keywords: Robot-assisted surgery, socio-material configurations, human-computer interaction, design artifacts, research-through-design, surgical teamwork, adverse events, da Vinci system, human-robot interaction, surgical training.

Background and Problem

• Problem / challenge: Existing research in human-computer interaction (HCI) and human-robot interaction (HRI) has acknowledged the importance of socio-material configurations in robotic systems, but capturing and reflecting on these configurations in RAS remains challenging. There is a lack of design artifacts specifically tailored to RAS that enable collaborative engagement with these configurations.
• Significance: Understanding and improving socio-material configurations in RAS is critical to addressing challenges such as communication barriers, workflow disruptions, and adverse events, which can compromise patient safety and surgical outcomes.
• Motivation and related work: Prior work has explored how robotic systems influence surgical practices, team dynamics, and decision-making. However, gaps remain in tools that facilitate reflection on socio-material configurations, particularly during adverse events in RAS. This paper builds on calls for designerly inquiries in HRI to address these gaps.

Solution

• Proposed approach: Development of Visual RAS (ViRAS) scenarios as design artifacts to represent and reflect on socio-material configurations in RAS, focusing on adverse events.
• Novelty:
  1. Creation of six ViRAS scenarios to visualize and reflect on socio-material configurations in RAS.
  2. Use of ViRAS-guided interviews with experienced RAS surgeons to derive insights for future RAS design.
  3. Application of a research-through-design (RtD) approach to develop intermediate-level knowledge for HRI in clinical settings.
• Procedure and key techniques:
  1. Phase 1: Eliciting - Observed six RAS procedures to document socio-material configurations during adverse events.
  2. Phase 2: Translating - Developed and refined ViRAS scenarios through a storyboarding approach and design critique sessions.
  3. Phase 3: Contextualizing - Conducted ViRAS-guided interviews with seven experienced RAS surgeons to reflect on configurations and identify opportunities for future RAS design.

Results

• Concrete findings:
  • Identified six recurring adverse events in RAS, such as robotic arm collisions and impaired visibility due to blood or organ obstruction.
  • Developed six ViRAS scenarios to represent these events, incorporating visual depictions of actors, actions, and interactions.
  • Surgeons highlighted the potential of ViRAS scenarios for improving situational awareness, communication, and training in RAS.
• Advantage over baselines:
  • ViRAS scenarios provide a novel, visual medium for reflecting on socio-material configurations, addressing gaps in existing HRI tools.
  • Surgeons found the scenarios useful for onboarding less experienced team members and for promoting shared understanding of RAS procedures.
• Experiments / evaluation:
  • Conducted design critique sessions with five HCI and HRI experts to refine ViRAS scenarios.
  • Conducted ViRAS-guided interviews with seven experienced RAS surgeons to evaluate the scenarios’ applicability and gather insights for future RAS design.
• Limitations and future work:
  • Observations were limited to a single hospital using the da Vinci Xi system, which may affect generalizability.
  • Recruitment challenges led to a small sample size of surgeons, primarily from Germany.
  • Future work includes extending observations to other RAS platforms and diverse surgical teams, as well as exploring the use of ViRAS scenarios in other HRI contexts.

Summary

This paper introduces ViRAS scenarios as a novel tool for reflecting on socio-material configurations in robot-assisted surgery (RAS). Developed through a research-through-design approach, the scenarios were informed by observations of six RAS procedures and refined through design critique sessions and interviews with experienced surgeons. The findings highlight the potential of ViRAS scenarios to improve situational awareness, communication, and training in RAS. While limited to a single hospital and the da Vinci Xi system, the approach offers a promising foundation for future research and design in HRI, with potential applications beyond surgical contexts.