Robot Assisted Surgery (RAS)
Lead Research Organisation:
University of Edinburgh
Department Name: College of Arts, Humanities & Social Sci
Abstract
Robot Assisted Surgery (RAS) is changing surgical practice, radically altering how surgical skills are learned and performed. As robotic capabilities have been shown to change surgical team dynamics, evidence suggests that RAS systems may potentially alter the knowledge and skills required for safe surgical practice.
Thus, incompatibilities between traditional processes and emerging innovations threaten to compromise patient safety, workforce, and data security. The proposed project explores the transformative consequences of RAS within UK surgical practice by investigating the introduction of CMR's Versius system. It will inform how NHS teams are learning to exploit opportunities or 'affordances' of new technology, providing insight into whether current robotic training programmes are safe and align with changing practice.
The research will answer three questions:
(1) How is RAS integrated into pre-existing hospital systems (e.g. training, data analytics, organisational, legislative and administrative)?
(2) To what extent does adoption of new RAS systems and the consequent hybridity between technology and surgeon, alter the embodiment, performance and acquisition of surgical knowledge and skills?
(3) To what extent is RAS altering the accountability and governance of surgical practice?
Context:
Social Shaping and Social Learning Frameworks
Building upon the Social Shaping of Technology (SST) this research will conceptualise innovation as a "garden of forking paths" (Williams and Edge, 1996:866). I will analyse processes of "social learning" which describe the active roles of numerous actors, including users and developers, as they interact with artefacts and one another to (re)shape technology over time. Central to the proposed research is Fleck's (1988:9) "Innofusion" where innovation extends beyond design into implementation and users become influential facilitators of innovation (Fleck, 1988; Fleck et al., 1990; Stewart and Williams, 2005). Exploring how ANT, SST, Social Learning and Innofusion relate to Versius allows an original contribution to knowledge by tracking innovation past design into implementation, observing processes of "learning by trying" (Fleck, 1994:649) and deconstructing the mediation roles of strategically designed actor-objects within human relationships (Yaneva, 2009).
The Sociology of Biomedicine has explored the increasingly socio-technological mediation of the "clinical gaze", whereby power of medical diagnosis revolves around physicians' perceptual experience (Foucault 1963). Drawing inspiration from Haraway (1991) and engaging with Clarke et al.'s (2003:161) concept of "biomedicalization", the proposed research will contest traditional philosophical conceptualisations of mind and body. It will empirically explore shifting boundaries between humans and machines, virtual and physical. Investigating hybridity between technology and surgeon will illustrate how bodily boundaries materialise during social interaction (Haraway, 1991:208) and facilitate critical evaluation of Bernát's (2015:40) claim that technological extensions have become the body's new natural environment.
Methods:
A mixed method, qualitative study will employ repeated in-depth, semi-structured interviews, non-participant observation and multichannel video recordings to ascertain how responsibility and accountability are mediated and (re)configured. Focusing on processes of social learning will unearth how technology is shaped by the users, how practice is shaped by the technology and whether or not these processes influence surgical governance by taking place internally or externally from communities of practice.
Impact
This research will contribute towards establishing optimum RAS usage, regulating medical innovations and promoting safe surgical practice. Findings will advance debates in the fields of robotics and medicine, offering data that can be applied to robotic training, policy and government
Thus, incompatibilities between traditional processes and emerging innovations threaten to compromise patient safety, workforce, and data security. The proposed project explores the transformative consequences of RAS within UK surgical practice by investigating the introduction of CMR's Versius system. It will inform how NHS teams are learning to exploit opportunities or 'affordances' of new technology, providing insight into whether current robotic training programmes are safe and align with changing practice.
The research will answer three questions:
(1) How is RAS integrated into pre-existing hospital systems (e.g. training, data analytics, organisational, legislative and administrative)?
(2) To what extent does adoption of new RAS systems and the consequent hybridity between technology and surgeon, alter the embodiment, performance and acquisition of surgical knowledge and skills?
(3) To what extent is RAS altering the accountability and governance of surgical practice?
Context:
Social Shaping and Social Learning Frameworks
Building upon the Social Shaping of Technology (SST) this research will conceptualise innovation as a "garden of forking paths" (Williams and Edge, 1996:866). I will analyse processes of "social learning" which describe the active roles of numerous actors, including users and developers, as they interact with artefacts and one another to (re)shape technology over time. Central to the proposed research is Fleck's (1988:9) "Innofusion" where innovation extends beyond design into implementation and users become influential facilitators of innovation (Fleck, 1988; Fleck et al., 1990; Stewart and Williams, 2005). Exploring how ANT, SST, Social Learning and Innofusion relate to Versius allows an original contribution to knowledge by tracking innovation past design into implementation, observing processes of "learning by trying" (Fleck, 1994:649) and deconstructing the mediation roles of strategically designed actor-objects within human relationships (Yaneva, 2009).
The Sociology of Biomedicine has explored the increasingly socio-technological mediation of the "clinical gaze", whereby power of medical diagnosis revolves around physicians' perceptual experience (Foucault 1963). Drawing inspiration from Haraway (1991) and engaging with Clarke et al.'s (2003:161) concept of "biomedicalization", the proposed research will contest traditional philosophical conceptualisations of mind and body. It will empirically explore shifting boundaries between humans and machines, virtual and physical. Investigating hybridity between technology and surgeon will illustrate how bodily boundaries materialise during social interaction (Haraway, 1991:208) and facilitate critical evaluation of Bernát's (2015:40) claim that technological extensions have become the body's new natural environment.
Methods:
A mixed method, qualitative study will employ repeated in-depth, semi-structured interviews, non-participant observation and multichannel video recordings to ascertain how responsibility and accountability are mediated and (re)configured. Focusing on processes of social learning will unearth how technology is shaped by the users, how practice is shaped by the technology and whether or not these processes influence surgical governance by taking place internally or externally from communities of practice.
Impact
This research will contribute towards establishing optimum RAS usage, regulating medical innovations and promoting safe surgical practice. Findings will advance debates in the fields of robotics and medicine, offering data that can be applied to robotic training, policy and government
Organisations
People |
ORCID iD |
| Gillian Haddow (Primary Supervisor) | |
| Rachel Simpson (Student) |