A Developmental Perspective to Studying Objects in Robotic Surgery

  • Laura Seppänen
  • Laure Kloetzer
  • Jarno Riikonen
  • Mikael Wahlström
Conference paper
Part of the IFIP Advances in Information and Communication Technology book series (IFIPAICT, volume 489)


Drawing on interventionist activity theoretical approaches, this paper describes a method of self-confrontation as a way in which to study objects in technology-mediated practices. In addition to research interests, the aim of examining the objects is to develop the capacity of professionals and organizations to work and learn better in complex technology-mediated work. The method was applied in robotic surgery, in which instruments are tele-operated by a surgeon. The robot offers better, collective visualization of the area under surgical operation than previous techniques. In particular, the paper shows how objects were revealed and new objects emerged during the intervention. We suggest that activity theoretical developmental interventions such as self-confrontations may help understand the complexity and evolution of objects, and thus contribute to studies of technology and organizations.


Developmental intervention research Object Robotic surgery Activity theory Self-confrontation 



Thanks to Leena Norros for her useful comments. We also thank all the surgeons and researchers involved in this study for their contribution. Thanks are extended to the two anonymous reviewers for their valuable comments, and Alice Lehtinen for the language check. This study is part of the WOBLE research project (Developing new forms of work-based learning for the age of digitalization), funded by the Finnish Work Environment Fund, and part of the Future of Learning, Knowledge and Skills programme of the Academy of Finland.


  1. 1.
    Orlikowski, W., Scott, S.: Sociomateriality: challenging the separation of technology, work and organization. Acad. Manage. Ann. 2(1), 433–474 (2008)CrossRefGoogle Scholar
  2. 2.
    Mol, A.: The Body Multiple: Ontology in Medical Practice. Duke University Press, Durham (2002)CrossRefGoogle Scholar
  3. 3.
    Tolman, C.: The metaphysic of relations in klaus riegel’s “dialectics” of human development. Hum. Dev. 24, 33–51 (1981)CrossRefGoogle Scholar
  4. 4.
    Chia, R.: Essai: time, duration and simultaneity: rethinking process and change in organizational analysis. Org. Stud. 23(6), 863–868 (2002)CrossRefGoogle Scholar
  5. 5.
    Midgley, G.: Systemic Intervention: Philosophy. Methodology and Practice. Kluwer Academic/Plenum Publishers, New York (2000)CrossRefGoogle Scholar
  6. 6.
    Engeström, Y.: Foreword: formative interventions for expansive learning. In: Virkkunen, J., Newnham, D.S. (eds.) The Change Laboratory. A Tool for Collaborative Development of Work and Education, pp. 15–18. Sense Publishers, Rotterdam (2013)Google Scholar
  7. 7.
    Cerf, M.: Is participatory research a scientific practice? J. Rural Stud. 27, 414–418 (2011)CrossRefGoogle Scholar
  8. 8.
    Kloetzer, L., Seppänen, L.: Dialogues and interactions as “the nursery for change”. Outlines Crit. Pract. Stud. 15(2), 1–4 (2014)Google Scholar
  9. 9.
    Saari, E., Hasu, M., Honkaniemi, L., Tuominen, T., Kallio, K., Lehtonen, M.: Co-development and retooling as new roles for applied research. In: Russo-Spena, T., Mele, C., Nuutinen, M. (eds.) Co-innovation: Activity, Practice. Learning and Social Context in Innovation. Springer, Heidelberg (2016)Google Scholar
  10. 10.
    Kostulski, K., Kloetzer, L.: Controversy as a developmental tool in cross-self confrontation. Outlines Crit. Pract. Studies 15(2), 54–73 (2014)Google Scholar
  11. 11.
    Engeström, R.: The interplay of developmental and dialogical epistemologies. Outlines Crit. Pract. Stud. 15(2), 119–138 (2014)Google Scholar
  12. 12.
    Clot, Y.: Clinic of activity: the dialogue as an instrument. In: Sannino, A., Daniels, H., Gutiérrez, K. (eds.) Learning and Expanding with Activity Theory, pp. 286–302. Cambridge University Press, Cambridge (2009)CrossRefGoogle Scholar
  13. 13.
    Kloetzer, L.: Development of professional concepts through work analysis: tech diving under the loop of activity clinic. Mind Cult. Activ. 20(4), 318–337 (2012)CrossRefGoogle Scholar
  14. 14.
    Vygotsky, L.S.: La Signification historique de la crise en psychologie. Delachaux et Niestlé, Lausanne (1927/1999)Google Scholar
  15. 15.
    Vygotsky, L.S.: La Méthode instrumentale en psychologie. In: Schneuwly, B., Bronckart, J.-P. (eds) Vygotsky aujourd’hui. Delachaux & Niestlé, Neuchâtel-Paris (1930/1985)Google Scholar
  16. 16.
    Vygotsky, L.S.: Défectologie et déficience mentale. Delachaux et Niestlé, Neuchâtel (1935/1994)Google Scholar
  17. 17.
    Vygotsky, L.S.: Histoire du développement des fonctions psychiques supérieures. La Dispute, Paris (2014)Google Scholar
  18. 18.
    Norros, L., Savioja, P., Koskinen, H.: Core-Task Design: A Practice-Theory Approach to Human Factors. Morgan & Claypool Publishers, San Rafael (2015)Google Scholar
  19. 19.
    Savioja, P., Norros, L., Salo, L., Aaltonen, I.: Identifying resilience in proceduralised accident management activity of npp operating crews. Saf. Sci. 68, 258–274 (2014)CrossRefGoogle Scholar
  20. 20.
    Engeström, Y.: Learning by Expanding. An Activity-Theoretical Approach to Developmental Research. Orienta-Konsultit, Helsinki (1987)Google Scholar
  21. 21.
    Seppänen, L.: Creating tools for farmers’ learning: an application of developmental work research. Agri. Syst. 73(1), 129–145 (2002)CrossRefGoogle Scholar
  22. 22.
    Seppänen, L., Toiviainen, H.: Relational agency in the development of tools of service networks. In: Edwards, A. (ed.) Working Relationally in and across Practices: Cultural-Historical Approaches to Collaboration. Oxford University Press, Oxford (in press)Google Scholar
  23. 23.
    Leont’ev, A.N.: Activity, Consciousness, and Personality. Prentice-Hall, Englewood Cliffs (1978)Google Scholar
  24. 24.
    Su, L.-M., Smith, J.A.: Laparoscopic and Robotic-Assisted Laparoscopic Radical Prostatectomy and Pelvic Lymphadetectomy. In: Kavoussi, L.R., Novick, A.C., Partin, A.W., Peters, C.A. (eds.) Campbell-Walsh Urology, 10th edn, pp. 2833–2849. Elsevier Inc., Philadelphia (2012)Google Scholar
  25. 25.
    Moorthy, K., Munz, Y., Dosis, A., Hernandez, J., Martin, S., Bello, F., Rockall, T., Darzi, A.: Dexterity enhancement with robotic surgery. Surg. Endosc. 18(5), 790–795 (2004)CrossRefGoogle Scholar
  26. 26.
    Hussain, A., Malik, A., Halim, M.U., Ali, A.M.: The use of robotics in surgery: a review. Int. J. Clin. Pract. 68(11), 1376–1382 (2014)CrossRefGoogle Scholar
  27. 27.
    Taari, K., Aaltomaa, S., Nurmi, M., Parpala, T., Tammela, T. (eds.): Urologia. Duodecim, Helsinki (2013)Google Scholar
  28. 28.
    Healey, A.N., Benn, J.: Teamwork enables surgical control and a new model for a surgical system emerges. Cogn. Technol. Work 11(4), 255–265 (2009)CrossRefGoogle Scholar
  29. 29.
    Nyssen, A.-S., Blavier, A.: Investigating expertise, flexibility and resilience in socio-technical environments: a case study in robotic surgery. In: Hollnagel, E., Braithwaite, J., Wears, R. (eds.) Resilient Health Care, vol. 1, pp. 97–110. Ashgate Publishing Limited, Hampshire (2013)Google Scholar
  30. 30.
    Aaltonen, I., Wahlström, M.: Evaluating technological solutions for improving user experience, learning, and operation outcome in robotic surgery (Manuscript in preparation)Google Scholar
  31. 31.
    Roulette, G.D., Couret, M.J.: Future directions and alternate systems for robotic surgery. In: Kroh, M., Chalikonda, S. (eds.) Essentials of Robotic Surgery, pp. 201–214. Springer International Publishing, Basel (2015)Google Scholar
  32. 32.
    Flyvbjerg, B., Landman, T., Schram, S.: Introduction: new directions in social science. In: Flyvbjerg, B., Landman, T., Schram, S. (eds.) Real Social Science: Applied Phronesis. Cambridge University Press, Cambridge (2012)CrossRefGoogle Scholar
  33. 33.
    Nicolini, D.: Practice Theory, Work, and Organization. An Introduction. Oxford University Press, Oxford (2013)Google Scholar
  34. 34.
    Kloetzer, L., Clot, Y., Quillerou-Grivot, E.: Stimulating dialogue at work: the activity clinic approach to learning and development. In: Fillietaz, L., Billet, S. (eds.) Francophone Perspectives of Learning Through Work: Conceptions, Traditions and Practices, pp. 49–70. Springer, New York (2015)CrossRefGoogle Scholar
  35. 35.
    Sitri, F.: L’Objet du débat. Presses Sorbonne, Nouvelle (2003)Google Scholar
  36. 36.
    Kloetzer, L., Kostulski, K.: “We Are Not Gurus”. Religious Activity Through an Interlocutory Analysis of Sunday Homily (submitted)Google Scholar
  37. 37.
    Seppänen, L., Riikonen, J.: Learning interpretativeness for sustainability: exploring the self-confrontation method in robotic surgery. In: Heikkinen A., Harju, A. (eds) Adult Education and the Planetary Condition: Freedom and Responsibility in Liberal Adult Education, pp. 124–133. Accessed 05 Oct 2016
  38. 38.
    Rückriem, G.: Digital technology and mediation: a challenge to activity theory. In: Sannino, A., Daniels, H., Gutiérrez, K. (eds.) Learning and Expanding with Activity Theory, pp. 88–111. Cambridge University Press, Cambridge (2009)CrossRefGoogle Scholar
  39. 39.
    Kaptelinin, V.: The object of activity: making sense of the sense-maker. Mind Cult. Activ. 12(1), 4–18 (2005)CrossRefGoogle Scholar
  40. 40.
    Nardi, B.: Objects of desire: power and passion in collaborative activity. Mind Cult. Activ. 12(1), 37–51 (2005)CrossRefGoogle Scholar

Copyright information

© IFIP International Federation for Information Processing 2016

Authors and Affiliations

  • Laura Seppänen
    • 1
  • Laure Kloetzer
    • 2
  • Jarno Riikonen
    • 3
  • Mikael Wahlström
    • 4
  1. 1.Finnish Institute of Occupational HealthHelsinkiFinland
  2. 2.University of NeuchâtelNeuchâtelSwitzerland
  3. 3.Pirkanmaa Hospital DistrictTampereFinland
  4. 4.VTT Technical Research Centre of Finland Ltd.EspooFinland

Personalised recommendations