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Examining surgeon stress in robotic and laparoscopic surgery

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Abstract

Robotic surgery may decrease surgeon stress compared to laparoscopic. To evaluate intraoperative surgeon stress, we measured salivary alpha-amylase and cortisol. We hypothesized robotic elicited lower increases in surgeon salivary amylase and cortisol than laparoscopic. Surgical faculty (n = 7) performing laparoscopic and robotic operations participated. Demographics: age, years in practice, time using laparoscopic vs robotic, comfort level and enthusiasm for each. Operative data included operative time, WRVU (surgical “effort”), resident year. Saliva was collected using passive drool collection system at beginning, middle and end of each case; amylase and cortisol measured using ELISA. Standard values were created using 7-minute exercise (HIIT), collecting saliva pre- and post-workout. Linear regression and Student’s t test used for statistical analysis; p values < 0.05 were significant. Ninety-four cases (56 robotic, 38 laparoscopic) were collected (April–October 2022). Standardized change in amylase was 8.4 ± 4.5 (p < 0.001). Among operations, raw maximum amylase change in laparoscopic and robotic was 23.4 ± 11.5 and 22.2 ± 13.4; raw maximum cortisol change was 44.21 ± 46.57 and 53.21 ± 50.36, respectively. Values normalized to individual surgeon HIIT response, WRVU, and operative time, showing 40% decrease in amylase in robotic: 0.095 ± 0.12, vs laparoscopic: 0.164 ± 0.16 (p < 0.02). Normalized change in cortisol was: laparoscopic 0.30 ± 0.44, robotic 0.22 ± 0.4 (p = NS). On linear regression (p < 0.001), surgeons comfortable with complex laparoscopic cases had lower change in normalized amylase (p < 0.01); comfort with complex robotic was not significant. Robotic may be less physiologically stressful, eliciting less increase in salivary amylase than laparoscopic. Comfort with complex laparoscopic decreased stress in robotic, suggesting laparoscopic experience is valuable prior to robotic.

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Data availability

No datasets were generated or analyzed during the current study.

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The authors have not disclosed any funding.

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Authors and Affiliations

  1. Department of Surgery, University of South Florida Morsani College of Medicine, Harbourside Medical Tower, 5 Tampa General Circle, Suite 410, Tampa, FL, 33606, USA

    Joseph Sujka, Emily A. Grimsley, Mcwayne Weche, Haroon Janjua, Zhiyong Mi, Carolina Martinez, Vic Velanovich, Robert D. Bennett, Salvatore Docimo, Adham R. Saad, Christopher DuCoin & Paul C. Kuo

  2. Morsani College of Medicine, University of South Florida, Tampa, FL, USA

    Abrahim Ahmed, Richard Kang & Zhiyong Mi

  3. Department of Gynecologic Surgery, Tampa General Hospital, Tampa, FL, USA

    Diana English

Authors
  1. Joseph Sujka
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  2. Abrahim Ahmed
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  3. Richard Kang
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  4. Emily A. Grimsley
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  5. Mcwayne Weche
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  6. Haroon Janjua
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  7. Zhiyong Mi
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  8. Diana English
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  9. Carolina Martinez
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  10. Vic Velanovich
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  11. Robert D. Bennett
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  12. Salvatore Docimo
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  13. Adham R. Saad
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  15. Paul C. Kuo
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Contributions

JS, PK, ZM, VV, SD, and CD contributed to the study conception and design. Material preparation and data collection were performed by JS, AA, RK, EG, MW, ZM, DE, CM, RB, S.D., AS, and PK. Data analysis was performed by HJ, EG, AA, and PK. The first draft of the manuscript was written by AA, JS, and RK and all authors reviewed and provided revisions to the manuscript. All authors read and approved the final manuscript.

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Correspondence to Joseph Sujka.

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Sujka, J., Ahmed, A., Kang, R. et al. Examining surgeon stress in robotic and laparoscopic surgery. J Robotic Surg 18, 82 (2024). https://doi.org/10.1007/s11701-024-01834-9

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