Transformation of work and new meanings in surgery by robots

Introduction More complex work systems evolve through the incorporation of new mediations such as new technologies, deepening the division of labour, and development of sciences. Local labor processes increasingly embody capabilities and knowledge that are developed in the broader society instead of those based on experience in the local context (Marx, 1976). New technologies affect work and organizing in many ways. According to Pérez (2002), technological breakthroughs provide, not only a set of generic technologies but organizational principles as well, finally leading to the modernization and regeneration of the whole productive system, a new 'techno-economic paradigm'. Organizational and institutional transformations - and perhaps also the consequent new meanings of work - occur only with delay after technological changes. Theory In empirical sociological research, 'meaning' often refers to symbolism that people attach to certain objects or functions (Alasuutari, 1999). Our approach to meaning is informed by the notion of the object of work, which comes from the cultural-historical activity theory. The object is something both given, as part of independent reality, and projected by human interpretations. In this interpreted, need-related capacity, the object gains a motivating force that gives shape and directs activities (Y. Engeström, Puonti & Seppänen, 2003). The collective, or societal, object and motive of a work activity is embedded in the way in which people construct the meaning of their work in everyday situations. However, individuals' meaning construction is not limited to the collective or societal objects and meanings (Bratus, 2005; R. Engeström, 2014; Stetsenko, 2005). New mediations such as technological devices affect not only the interpreted side of the work object, but also the whole work system with its rules and division of labour. Our approach to meaning is also informed by the notion of interpretative practice. It refers to an active process of engaging in work such as dealing constantly with uncertainty, appropriating relevant scientific knowledge in embodied work, and generalizing deeper understanding of the development and systemic interdependencies of the object. The assumption is that the increasing complexity of work requires interpretative mode of working, and that it simultaneously promotes learning and meaningfulness for work practitioners. (Wahlström, Norros, Seppänen, Schaupp & Toiviainen, 2014). Robot-assisted surgery Technology has revolutionized surgery in reducing anatomical invasiveness and increasing the range of available surgical measures. Empirically, we investigate the surgery in urology that is assisted with computerized surgical device using mechanical robotic arms. Work with it is more teleoperation with limited automation rather than an autonomous robot. By incorporating sophisticated wristed technology at the terminal ends of the robotic instruments, a surgeon can operate, dissect, and suture with the facility of a human wrist (Su & Smith, 2012). The surgeon, operating distanced from the patient, needs to trust that the robot functions exactly as promised. It provokes many changes and new constraints in the way to operate and in the role of involved actors (Blavier & Nyssen, 2010). Robot-assisted surgery transforms in-depth the human-machine system. Surgical action becomes increasingly remote, and technology has drawn the operating room team more closely into its control (Healey & Benn, 2009). Data, method and findings Our first aim is to examine how this new technology transforms the surgeons' work and its terms of reference. We do this by investigating how surgeons, in interviews, depict the changes when moving from open to robotic surgery. Changes occur on many levels, ranging from global (such as the international maintenance of the device) to organizational, team, and to individual practitioners' work. The second aim of our presentation is to analyse, what kinds of new meaning this technological transformation has brought. The analysis is guided by the notions of object construction and interpretative mode of work. This exploratory study about the new meanings in surgeons' work will help us better understand the learning challenges and the role of interpretativeness in the development of this complex, robotic-assisted, science-related and bodily work.