Specific stressors in endonasal skull base surgery with and without navigation

Area of Science:

• Organizational Psychology
• Surgical Innovation
• Medical Device Technology

Background:

• Modern organizational psychology aims to identify and mitigate workplace stress.
• Transnasal surgeries present unique mental and physical demands for surgeons.
• Navigation systems are increasingly used in endoscopic sinus surgery.

Purpose of the Study:

• To objectively measure mental and physical demands during transnasal surgery.
• To compare stress levels with and without the use of a navigation system.
• To identify key stressors and calming factors in the operating room environment.

Main Methods:

• Biometric parameters (heart rate, heart rate variability, respiratory frequency, masseter tone) were monitored in surgeons during 40 endonasal surgeries.
• Surgeries were divided into two groups: 20 with navigation and 20 without.
• Experienced rhinosurgeons (>250 FESS procedures) performed the surgeries.

Main Results:

• Stress was identified by increased heart rate and decreased heart rate variability.
• No significant difference in stress levels was observed between surgeries with and without navigation.
• Other stressors included time pressure, OR distractions, equipment failure, bleeding, and complex procedures.

Conclusions:

• Navigation systems did not significantly reduce surgeon stress in this study.
• OR environment, team dynamics, and equipment reliability are crucial factors influencing surgeon stress.
• Effective training and motivated OR personnel are essential for minimizing stress and improving surgical outcomes.