Is non-stop always better? examining assumptions behind the concept of flow disruptions in studies of robot-assisted surgery

The increasing use of robot assisted surgery (RAS) poses new possibilities and challenges for surgeons and teams. RAS offers ergonomic and technical advantages, but teamwork is challenged by the fact that the surgeon is positioned in a console away from the patient and the team. RAS teams are learning to work in this set-up, and research is increasing to support this learning. A relatively prominent analytical concept in this research is ‘flow disruptions’, applied to describe disturbances in the progression of surgery, but carrying three important potential problems for analysis that we highlight in this article. First, the term is applied to describe a wide range of events that span from the minor to the massive. This span complicates comparison. Secondly, the term can easily come to imply a misleading ideal of uninterrupted flow. Thirdly, the labelling of certain events as flow disruptions primarily relates to efficiency, but also to performance or safety. These are concerns that are separate, but sometimes incompatible or even mutually exclusive in practice, as we argue in the article.