Department of Health Sciences Research, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA; Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
Department of Health Sciences Research, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
Appl Ergon. 2019 Jul;78:277-285. doi: 10.1016/j.apergo.2018.06.005. Epub 2018 Jun 28.
Advanced minimally invasive procedures may cause postural constraints and increased workload and stress for providers. This study compared workload and stress across surgical team roles for 48 laparoscopic cholecystectomies (4-port vs single-port) using a task load index (NASA-TLX), a procedural difficulty question, and salivary stress hormones. Statistical analyses were performed based on the presence intra-cluster correlation within team roles, at α=0.05. The single-port technique resulted in an 89% increase in physical workload for the surgeon and 63% increase for the assistant (both p<0.05). The surgeon had significantly higher salivary stress hormones during single-port surgeries. The degree of procedural difficulty was positively correlated between the surgeon and most roles: resident (r=0.67), assistant (r=0.81), and technician (r=0.81). There was a statistically significant positive correlation between the surgeon and assistant for all selfreported workload measures (p<0.05). The single-port technique requires further improvement to balance surgical team workload for optimal patient safety and satisfaction.
先进的微创手术可能会给提供者带来姿势限制和增加工作量和压力。本研究通过任务负荷指数（NASA-TLX）、手术难度问题和唾液应激激素，比较了 48 例腹腔镜胆囊切除术（4 端口与单端口）中手术团队角色的工作量和压力。基于团队角色内的群内相关，在 α=0.05 时进行了统计分析。单端口技术使外科医生的体力工作量增加了 89%，助手的体力工作量增加了 63%（均 p<0.05）。外科医生在单端口手术期间唾液应激激素水平显著升高。手术难度程度与外科医生和大多数角色之间呈正相关：住院医师（r=0.67）、助手（r=0.81）和技术员（r=0.81）。外科医生和助手之间的所有自我报告的工作量指标均呈统计学显著正相关（p<0.05）。单端口技术需要进一步改进，以平衡手术团队的工作量，从而实现最佳的患者安全和满意度。
