Laparoscopic Surgical Team Stress Measures During Randomized Controlled Trials of 4-port vs. Single Incision Cholecystecomies: A Pilot Study

摘要

The Institute of Medicine lists investigations of the comparative effectiveness for minimally invasivesurgical procedures as a research priority. As new minimally invasive procedures are developed,comparisons of the resulting workload contribute valuable information about the impact of the newprocedures. Recent reports suggest that surgeon workload can influence patient outcomes. Measurementsof stress and fatigue for the surgical team participating in a randomized NIH supported trial of singleincision versus traditional laparoscopic cholecystectomy were obtained. These stress measures showed thatthe SURG-TLX was sensitive to the difficulty of the surgery. The SURG-TLX and a surgical difficultyscore was obtained from the surgical team for 16 laparoscopic surgeries by surgical approach (8 SILC and8 4-port) showed that for this small sample size, there were no statistically significant differences in lengthof surgery, degree of difficulty, nor patient considerations such as post-operative pain scores. In addition,no statistically significant differences in the individual Surg-TLX subscale scores or Surg-TLX total for thesurgical team overall or for the surgeon alone by surgical platform. This is likely due to the small samplesize reducing the power of the tests.