Relax, it's just laparoscopy! A prospective randomized trial on heart rate variability of the surgeon in robot-assisted versus conventional laparoscopic cholecystectomy.

BACKGROUND: 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 randomized 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: Both heart rate and HRV (the low-frequency band/high-frequency band ratio) were significantly decreased when using robotic assistance. CONCLUSIONS: These data suggest the use of the daVinci® Surgical System leads to less physical and mental strain of the surgeon during surgery. However, assessing mental strain by means of HRV is cumbersome since there is no clear cutoff point or scale for maximum tolerated strain levels and its related effects on surgeon's health.

Effect of a stiff lifting belt on spine compression during lifting.

STUDY DESIGN: An in vivo study on weightlifters. OBJECTIVES: To determine if and how a stiff back belt affects spinal compression forces in weightlifting. SUMMARY OF BACKGROUND DATA: In weightlifting, a back belt has been reported to enhance intraabdominal pressure (IAP) and to reduce back muscle EMG and spinal compression forces. METHODS: Nine experienced weightlifters lifted barbells up to 75% body weight while inhaling and wearing a belt, inhaling and not wearing a belt, and exhaling and wearing a belt. IAP, trunk muscle EMG, ground reaction forces, and kinematics were measured. An EMG-assisted trunk model, including IAP effects, was used to calculate spinal compression and shear forces and to reveal the contribution of back muscles, abdominal muscles, and IAP to moment generation. RESULTS: The belt reduced compression forces by about 10%, but only when inhaling before lifting. The moment generated by IAP increased when wearing a belt and inhaling, but this moment was small and the increase was largely negated by the flexing moment generated by abdominal muscles. CONCLUSIONS: Wearing a tight and stiff back belt while inhaling before lifting reduces spine loading. This is caused by a moment generated by the belt rather than by the IAP.