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Robotically assisted laparoscopy benefits surgical performance under stress

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Abstract

While the benefits of robotic surgery for the patient have been relatively well established, little is known about the benefits for the surgeon. This study examined whether the advantages of robotically assisted laparoscopy (improved dexterity, a 3-dimensional view, reduction in tremors, etc.) enable the surgeon to better deal with stressful tasks. Subjective and objective (i.e. cardiovascular) responses to stress were assessed while surgeons performed on either a robotic or conventional laparoscopic system. Thirty-two surgeons were assigned to perform a surgical task on either a robotic system or a laparoscopic system, under three stress conditions. The surgeons completed self-report measures of stress before each condition. Furthermore, the surgeons’ cardiovascular responses to stress were recorded prior to each condition. Finally, task performance was recorded throughout each condition. While both groups reported experiencing similar levels of stress, compared to the laparoscopic group, the robotic group displayed a more adaptive cardiovascular response to the stress conditions, reflecting a challenge state (i.e. higher blood flow and lower vascular resistance). Furthermore, despite no differences in completion time, the robotic group performed the tasks more accurately than the laparoscopic group across the stress conditions. These results highlight the benefits of using robotic technology during stressful situations. Specifically, the results show that stressful tasks can be performed more accurately with a robotic platform, and that surgeons’ cardiovascular responses to stress are more favourable. Importantly, the ‘challenge’ cardiovascular response to stress displayed when using the robotic system has been associated with more positive long-term health outcomes in domains where stress is commonly experienced (e.g. lower cardiovascular disease risk).

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Correspondence to Samuel J. Vine.

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Conflict of interest

This research was funded by Intuitive Surgical Ltd. through their, ‘Surgical Clinical Robotics Research Grant’ Program. However, Intuitive Surgical Ltd. had no involvement in the design and execution of the research, or in the analysis or interpretation of the data presented. Therefore, Dr Lee Moore, Ms Elizabeth Waine, Dr Mark Wilson, Mr John McGrath, Prof Rich Masters, and Dr Samuel Vine have no conflicts of interest or financial ties to disclose.

Informed consent statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients before being included in the study.

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Moore, L.J., Wilson, M.R., Waine, E. et al. Robotically assisted laparoscopy benefits surgical performance under stress. J Robotic Surg 9, 277–284 (2015). https://doi.org/10.1007/s11701-015-0527-y

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  • DOI: https://doi.org/10.1007/s11701-015-0527-y

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