Table 1

Referencing strategies in robot-assisted surgery

StrategyClassificationDescription
Anatomy terms/verbal direction (AT)Speech Only
  • Speaker uses directional words without an accompanying gesture (ie, ‘go left’) to direct attention.

  • Speaker uses anatomic terms to direct attention (ie, ‘toward the umbilicus’).

Context dependent words (ie, here/there) (CD)Speech Only
  • Speaker says ‘Stop there’ without gesturing to specify the point at which the listener should come to rest in the surgical field.

Point/show (PT)Gesture Inclusive
  • Speaker uses instrument to point at referent.

  • Speaker uses instrument to grasp referent.

  • Speaker uses instrument to clear view of referent.

Functional movement (FM)Gesture Inclusive
  • Speaker retracts, cauterises or blunt dissects tissue and uses that touch to identify a referent.

Camera focus/movement (CF)Gesture Inclusive
  • Speaker zooms the camera in on referent.

  • Movement visible on the monitor is treated as salient by the speaker (ie, dripping blood).

Integrated communication (IC)Gesture Inclusive
  • Use of AT or CD in conjunction with PT, CF or FM.