A prospective randomised trial on heart rate variability of the surgeon in robot-assisted versus conventional laparoscopic cholecystectomy

Introduction: Laparoscopic surgery might be beneficial for the patient, but it imposes increased physical and mental strain on the surgeon. Robot-assisted laparoscopic surgery addresses some of the laparoscopic drawbacks and may potentially reduce mental strain. This could reduce the risk of surgeon’s fatigue, mishaps and strain-induced illnesses, which may eventually improve the safety of laparoscopic surgical procedures. Methods: To test this hypothesis, a randomised study was performed, comparing both heart rate and heart rate variability (HRV) of the surgeon as a measure of total and mental strain respectively during conventional and robot-assisted laparoscopic cholecystectomy. Results: Heart rate was decreased and heart rate variability was significantly increased using robotic assistance. Conclusion: These data suggest the use of the daVinci® Surgical System leads to less physical and less mental strain of the surgeon during surgery. However, assessing mental strain by means of heart rate variability is cumbersome since there is no clear cut-off point or scale for maximum tolerated strain levels and its related effects on surgeon’s health.