title: Robotically assisted laparoscopy benefits surgical performance under stress.
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).
authors.affiliation: School of Sport and Exercise, Faculty of Applied Sciences, University of Gloucestershire, Oxstalls Campus, Gloucester, UK.
authors.forename: Lee J
authors.initials: LJ
authors.lastname: Moore
authors.affiliation: Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, Devon, EX1 2LU, UK.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Wilson
authors.affiliation: Health Services Research Unit, Royal Devon and Exeter NHS Trust, Exeter, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Waine
authors.affiliation: Health Services Research Unit, Royal Devon and Exeter NHS Trust, Exeter, UK.
authors.forename: John S
authors.initials: JS
authors.lastname: McGrath
authors.affiliation: Institute of Human Performance, University of Hong Kong, Pokfulam, Hong Kong.|Faculty of Education, University of Waikato, Hamilton, New Zealand.
authors.forename: Rich S W
authors.initials: RS
authors.lastname: Masters
authors.affiliation: Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, Devon, EX1 2LU, UK. s.j.vine@exeter.ac.uk.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Vine
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002983:Clinical Competence / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D065287:Robotic Surgical Procedures / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000523:psychology*; D066231:Surgeons / Q000523:psychology* / Q000706:statistics & numerical data*; D013647:Task Performance and Analysis
keywords: Cardiovascular; Challenge and threat; Pressure; Psychology; Stress