Exploring Factors Influencing Patients Willingness to Consent to (Robotic-Assisted) Total Hip Arthroplasty
M.C. Lemmens (TU Delft - Technology, Policy and Management)
O. Oviedo-Trespalacios – Mentor (TU Delft - Safety and Security Science)
Perla J. Marang-van de Mheen – Graduation committee member (TU Delft - Safety and Security Science)
Neelke Doorn – Graduation committee member (TU Delft - Values Technology and Innovation)
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Abstract
Robotic-assisted surgical methods are advancing rapidly, offering potential advantages such as improved precision, accuracy, and reduced patient recovery times. However, widespread adoption depends not only on technological advancements but also on patient acceptance and willingness to consent. Informed consent plays a crucial role in the successful integration of robotic-assisted surgery into clinical practice, making it essential to understand the factors influencing patient decision-making.
This study investigates the key factors influencing patient willingness to consent to robotic-assisted total hip replacement surgery in the Netherlands, using a direct-effects model and an extended Technology Acceptance Model (eTAM). A questionnaire-based survey was conducted to assess trust, perceived usefulness (PU), perceived complexity (PC) and willingness to consent across five different surgical scenarios with varying levels of robotic involvement and surgeon presence.
Results indicated that trust and PU showed the strongest association with willingness to consent across all scenarios, emphasizing the need for healthcare providers to prioritize transparency, building trust and discussion risks and benefits. Testing the mediating effect of showed that PU did not act as a consistent mediating variable in any of the scenarios. ANOVA results revealed significant differences between surgical scenarios, with robotic-assisted surgery performed by a surgeon receiving the highest ratings in PU, trust, and willingness to consent. Remote surgery was perceived as the most complex surgical scenario. Participant preferred autonomous robotic surgery over conventional (manual) surgery, despite higher trust and willingness scores for the latter.
Participants also had varying views on the role of technicians in robotic surgery. While many saw their presence as essential for system reliability, others associated it with potential system flaws, emphasizing the need for clear communication about their role. Additionally, most participants mentioned the need for full disclosure regarding surgical methods, reinforcing the importance of patient autonomy.
These findings provide valuable insights for healthcare providers and policymakers to improve informed consent procedures and increase the adoption of robotic-assisted surgery. By addressing patient concerns through education, transparency and building trust, healthcare providers can improve patient comfort and willingness to consent to robotic (assisted) surgery.