Impact of single-incision laparoscopic cholecystectomy SILC versus conventional laparoscopic cholecystectomy CLC procedures on surgeon stress and workload: a randomized controlled trialReportar como inadecuado




Impact of single-incision laparoscopic cholecystectomy SILC versus conventional laparoscopic cholecystectomy CLC procedures on surgeon stress and workload: a randomized controlled trial - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Surgical Endoscopy

, Volume 30, Issue 3, pp 1205–1211

First Online: 21 July 2015Received: 30 March 2015Accepted: 09 June 2015

Abstract

IntroductionSingle-incision laparoscopic cholecystectomy SILC may lead to higher patient satisfaction; however, SILC may expose the surgeon to increased workload. The goal of this study was to compare surgeon stress and workload between SILC and conventional laparoscopic cholecystectomy CLC.

MethodsDuring a double-blind randomized controlled trial comparing patient outcomes for SILC versus CLC NCT0148943, surgeon workload was assessed by four measures: surgery task load index questionnaire Surg-TLX, maximum heart rate, salivary cortisol level, and instruments usability survey. The maximum heart rate and salivary cortisol levels were sampled from the surgeon before the random assignment of the surgical procedure, intraoperatively after the cystic duct was clipped, and at skin closure. After each procedure, the surgeon completed the Surg-TLX and an instrument usability survey. Student’s t tests, Wilcoxon rank sum test, and Kruskal–Wallis nonparametric ANOVAs on the dependent variables by the technique SILC vs. CLC were performed with α = 0.05.

ResultsTwenty-three SILC and 25 CLC procedures were included in the intent-to-treat analysis. No significant differences were observed between SILC and CLC for patient demographics and procedure duration. SILC had significantly higher post-surgery surgeon maximum heart rates than CLC p < 0.05. SILC also had significantly higher mean change in the maximum heart rate between during and post-procedure p < 0.05 than CLC. Salivary cortisol level was significantly higher during SILC than CLC p < 0.01. Awkward manipulation of the instruments and limited fine motions were reported significantly more frequently with SILC than CLC p < 0.01. In the surgeon-reported Surg-TLX, subscale of physical demand was significantly more demanding for SILC than CLC p < 0.05.

ConclusionsSurgeon heart rate, salivary cortisol level, instrument usability, and Surg-TLX ratings indicate that SILC is significantly more stressful and physically demanding than the CLC. Surgeon stress and workload may impact patients’ outcomes; thus, ergonomic improvement on SILC is necessary.

KeywordsSurgeon Laparoscopy SILC Workload Surg-TLX Stress  Download fulltext PDF



Autor: Amro M. Abdelrahman - Juliane Bingener - Denny Yu - Bethany R. Lowndes - Amani Mohamed - Andrea L. McConico - M. Susan 

Fuente: https://link.springer.com/article/10.1007/s00464-015-4332-5







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