Related Experiment Video
Updated: Apr 23, 2026

Single-Port Robotic-assisted Transaxillary Breast-conserving Surgery: A Prospective, Single-arm, Non-randomized Phase IIa Clinical Trial
Published on: August 19, 2025
Relax, it's just laparoscopy! A prospective randomized trial on heart rate variability of the surgeon in
Jeroen Heemskerk1, H Reinier Zandbergen, Sander W M Keet
1Department of General Surgery, Laurentius Hospital Roermond, Roermond, The Netherlands.
Background:
Laparoscopic surgery might be beneficial for the patient, but it imposes increased physical and mental strain on the surgeon. Robot-assisted laparoscopic surgery addresses some of the laparoscopic drawbacks and may potentially reduce mental strain. This could reduce the risk of surgeon's fatigue, mishaps and strain-induced illnesses, which may eventually improve the safety of laparoscopic surgical procedures.
Methods:
To test this hypothesis, a randomized study was performed, comparing both heart rate and heart rate variability (HRV) of the surgeon as a measure of total and mental strain, respectively, during conventional and robot-assisted laparoscopic cholecystectomy.
Results:
Both heart rate and HRV (the low-frequency band/high-frequency band ratio) were significantly decreased when using robotic assistance.
Conclusions:
These data suggest the use of the daVinci® Surgical System leads to less physical and mental strain of the surgeon during surgery. However, assessing mental strain by means of HRV is cumbersome since there is no clear cutoff point or scale for maximum tolerated strain levels and its related effects on surgeon's health.

