title: Stress Experienced by Obstetrics and Gynecology Residents during Planned Laparoscopy: A Prospective, Multicentric, Observational, Blinded, and Comparative Study.
abstract: OBJECTIVE
  To describe heart rate (HR) variations in surgical residents during laparoscopy and to assess their intraoperative stress.
  
  
  METHODS
  We performed a prospective, multicentric, observational, blinded, and comparative analysis of the HR in 75 obstetrics and gynecology residents during planned laparoscopy for infertility in five teaching hospitals with assisted reproductive technology centers. The surgical residents had neither heart disease nor were under medical treatment or using tobacco or drugs. We describe HR variations at 9 preselected operative steps using real-time noninvasive measures of the HR during laparoscopy.
  
  
  RESULTS
  Residents performed 124 laparoscopies for unexplained infertility. Their HR increased significantly during the introduction of the Palmer needle, umbilical port and second port, and during abdominopelvic exploration and dye test compared to the baseline HR, the HR after hand washing, at the end of surgery and during skin suture (91.6 ± 1.9, 104.8 ± 2.3, 95.3 ± 2.2, 93.7 ± 2.5, 90.7 ± 1.7 vs. 83.2 ± 1.6, 88.6 ± 1.9, 87.4 ± 2.1, 88.2 ± 1.9 bpm, respectively, p < 0.02).
  
  
  CONCLUSIONS
  Our results point to a potential stress for the surgeon assessed by HR variations during planned laparoscopy compared to the baseline HR before surgery. This 'static' stress can be repeated on the same day.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Jean Verdier, AP-HP, Bondy, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Ducarme
authors.forename: Alexandre
authors.initials: A
authors.lastname: Bricou
authors.forename: Olivier
authors.initials: O
authors.lastname: Chanelles
authors.forename: Christophe
authors.initials: C
authors.lastname: Sifer
authors.forename: Christophe
authors.initials: C
authors.lastname: Poncelet
mesh_terms: D000328:Adult; D002983:Clinical Competence; D005260:Female; D006176:Gynecology / Q000193:education*; D006339:Heart Rate / Q000502:physiology*; D006784:Hospitals, Teaching; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis; D007396:Internship and Residency / Q000706:statistics & numerical data*; D010535:Laparoscopy / Q000193:education* / Q000523:psychology; D008297:Male; D009774:Obstetrics / Q000193:education*; D011247:Pregnancy; D011446:Prospective Studies; D013315:Stress, Psychological / Q000453:epidemiology*