Assessing surgeon stress during urological interventions: A descriptive study using heart rate variability (uRRology)

Area of Science:

• Urology
• Surgical Stress Monitoring
• Physiological Monitoring

Background:

• Surgical environments induce significant stress, impacting surgeon well-being.
• Heart Rate Variability (HRV) serves as a validated physiological indicator of stress.
• Understanding surgeon stress is crucial for maintaining high-quality surgical care.

Purpose of the Study:

• To quantify physiological stress in surgeons during urological interventions using HRV.
• To investigate differences in stress responses between senior and junior surgeons.
• To establish the feasibility of HRV monitoring in routine surgical practice.

Main Methods:

• Prospective, unicentric study involving 171 urological interventions.
• Beat-by-beat heart rate (HR) recorded using a chest belt, with HRV analyzed in time (mean HR, RMSSD) and frequency (FFT spectrum HF) domains.
• Comparison of HRV parameters during baseline, incision, closure, and adverse events, differentiating between senior and junior surgeons.

Main Results:

• Senior surgeons exhibited significantly higher median differences in HR during incision and closure compared to juniors.
• Senior surgeons showed significantly lower high frequency (HF) power during incision and closure.
• Senior surgeons demonstrated significantly lower root mean square of successive differences (RMSSD) during incision, indicating higher stress levels.

Conclusions:

• HRV monitoring is feasible within standard urological surgical practice.
• Senior surgeons experience greater physiological stress responses during interventions compared to their junior counterparts.
• Findings highlight the need for stress management strategies for surgeons, particularly senior ones.