Objective assessment of stress and surgical performance during simulated robot-assisted laparoscopic surgery

MIS techniques achieved in the last decades have improved the quality of interventions and patient recovery, although there are still doubts about how they affect surgeons' health. This study aims to analyze the relationship between surgeon physiological and subjective stress parameters during laparoscopic and robot-assisted laparoscopic surgery (RALS) and the quality of surgical performance by means of wearable technology.

This study was conducted in a simulation environment with tasks involving hand-eye coordination and technical surgical skills. Sixteen surgeons from three different surgical disciplines participated in this study using both a conventional laparoscopic technique and the Versius® robotic platform for RALS. Two wearable sensors were used to analyze surgeons' physiological stress, as well as a subjective questionnaire for stress assessment during surgical practice (SURG-TLX).

The results of the data analysis showed that stress experienced was reduced in RALS when compared to conventional laparoscopy, and with it the percentage of errors committed. Novice surgeons performed better in most parameters compared to experienced microsurgeons.

Surgeons without previous experience in laparoscopic surgery showed an improvement in their stress and surgical performance when using robot-assisted surgery.