New research has examined the stresses surgeons experience during robot-assisted surgery.
In the study, seven experienced urologists were monitored during live operations, with multiple physiological signals recorded simultaneously as they performed robot-assisted procedures.
Each surgeon wore lightweight sensors that recorded brain activity via electroencephalography, shoulder and neck muscle activity via surface electromyography, and heart activity via electrocardiography.
Rather than interrupting mid-operation to ask how stressed they felt, the team used video-stimulated recall: each surgeon watched a recording of their own console view and marked the moments when they felt their stress level changed.
This enabled the researchers to match notable physiological patterns to specific moments of stress.
The team found that four physiological signals reliably tracked how stressed surgeons reported feeling:
A pattern of brain activity linked to mental arousal increased
Muscle tension in the upper shoulder increased
Heart rate increased
The natural variability between heartbeats decreased.
These signals moved together in a way that consistently aligned with how stressed surgeons said they felt, as confirmed by robust statistical analysis.
The results showcase how unobtrusive physiological monitoring can provide useful information for understanding the challenges faced by surgeons.
The study was published online in the journal Surgical Endoscopy.
The team was led by Professor Yoshihiro Shimomura of the Design Research Institute at Chiba University, Japan, and included Dr Kaiqi Wei and Dr Nanako Nakamura from the Graduate School of Science and Engineering, Chiba University, and Dr Shinichi Sakamoto from the Graduate School of Medicine, Chiba University.
Professor Shimomura said: ‘Combining surgeon-reported stress annotations with multimodal physiological monitoring is feasible in RAS and may provide a basis for identifying high-demand operative moments during postoperative review.’
The researchers see this approach as a way to better understand the challenges facing the wider surgical team and to create healthier working environments for healthcare professionals.
Prof Shimomura added: ‘Designing environments, equipment, and operational methods based on the results of this line of research will help manage doctors’ stress, improve surgical performance, and enhance surgeons’ own wellbeing. In addition, these findings could be applied to real-time stress-relief interventions for surgeons, triggering briefing protocols to enhance surgical safety and supporting stress management for beginners in training using double-console systems.’
