Objective evaluation of the effect of noise on the performance of a complex laparoscopic task

Noise in operating rooms has been found to be much higher than the recommended level of 45 dB. The aim of this study was to objectively evaluate the effect of noise and music on the performance of a complex surgical task.

Twelve surgeons with varying experience in laparoscopic suturing undertook 3 sutures in a laparoscopic trainer under 3 conditions: quiet, noise at 80 to 85 dB, and music. Other than the test conditions, all other conditions were standardized. A validated motion analysis system was used to assess performance. The tasks were recorded by video and played back to 2 blinded observers who rated the surgeons' performance on a global rating scale by observing the tasks for accuracy, knot quality, and number of nonpurposeful movements.

Time taken for the tasks (P=.78), total number of movements (P=.78), total path length (P=.47), global score (P=.54), accuracy, and knot quality remained unchanged across the 3 conditions. The main study measures had a high test-retest reliability and internal consistency. No learning effect was seen across the 3 conditions.

Surgeons can effectively "block out" noise and music. This is probably due to the high levels of concentration required for the performance of a complex surgical task. Future research should focus on the effect of these conditions on communication in the operating room.