Human-Robot Collaboration (HRC) in surgery is rarely a straightforward interaction between one human and one robot. In joint replacement surgeries performed with the Mako robot (Makoplasty), the robotic arm enhances surgical precision while also affecting how collaboration unfolds in the operating theater. Utilizing over 80 hours of hospital-based fieldwork, including observations of 15 Makoplasty surgeries and 10 interviews, we examine how the Mako robot shapes surgical HRC. We demonstrate how surgical teams coordinate via tacit cues, negotiated boundaries, and adaptive role shifts across phases of operation. Through vignettes, we highlight the pivotal role of supporting actors, such as nurses and robotic specialists, in maintaining flow and reveal how responsibility is distributed temporally among actors depending on task demands. We argue that surgical HRC is best understood as a multi-actor choreography rather than a surgeon-robot dyad, offering design implications for co-located surgical HRC systems that support distributed collaboration.

This article presents a human-centred design study examining how low-fidelity and embodied prototyping methods can elicit design-relevant knowledge for Robotic-Assisted Surgery (RAS). Focusing on femoral cement removal in Revision Total Hip Arthroplasty (rTHA), we conducted a design-led workshop involving a senior orthopaedic surgeon with expertise in complex revision cases, a surgical assistant, a robotics engineer from an industry partner developing orthopaedic surgical robots and a team of design researchers. Through scenario-based roleplay, task enactment and spatial configuration activities, we surfaced tacit, embodied and situated insights into anatomical factors, instrument design, surgeon–robot ergonomics, shared control models and operating theatre layout. These findings highlight challenges and opportunities for integrating robotic systems into complex surgical procedures and demonstrate how collaborative exploratory prototyping can support early stage reflection and interdisciplinary knowledge exchange. Rather than validating a specific solution, the study contributes both a transferable methodological approach for eliciting design insights in high-risk, highly constrained environments and formative insights into the design of RAS systems for rTHA.

This research investigates the application of tangible and embodied prototyping methods integrated with virtual simulation in Human-Robot Interaction (HRI). We present the development of the “kinematic puppet,” a reliable, reusable, adaptable, and accessible prototyping tool designed to facilitate stakeholder engagement in early-stage HRI research and development without requiring significant financial or time investments. The potential of this methodological approach is illustrated through a formative co-design workshop in Robotic Assisted Surgery (RAS), where the kinematic puppet, simple props and a low-fidelity anatomical model enabled stakeholders to externalise tacit knowledge through role-play scenarios. The case study suggests that combining physical and virtual approaches can support stakeholders in expressing concrete ideas for improving or changing the interaction, making abstract concepts tangible, with virtual simulation enabling rich data capture for further design development. This work contributes to the rapidly expanding toolbox of design approaches in HRI.

Human-Robot Collaboration (HRC) has many potential benefits to workers in various sectors but also inherently changes work practices, processes, and ways of thinking. Lupetti et al. [2] argue that design techniques and processes are needed to bridge the gap between the technical research driving HRC approaches and the sociocultural reality and needs of end-users. This demo presents the “kinematic puppet,” a novel, cost-effective, modular, and adaptable tangible interface to facilitate embodied exploration of robotic movements and interactions through roleplaying and Wizard-of-Oz prototyping, enabling the exploration of HRC concepts without requiring advanced skills in robotic programming and supporting more human-centered design in HRC.