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 well-being
Yoshihiro Shimomura
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 surgeons’ mid-operation to ask how stressed they felt, the team used video-stimulated recall. Simply put, after surgery, each surgeon watched a recording of their own console view and marked the moments when they felt their stress level changed, rating it on a scale of 0 to 9. This enabled the researchers to match notable physiological patterns to specific moments of stress without disrupting the procedure.
By statistically analyzing 151 of these stress-rated moments across the seven surgeons, 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 sped up, and the natural variability between heartbeats decreased. These signals moved together in a way that lined up consistently with how stressed surgeons said they felt, as confirmed through robust statistical analysis.
These results showcase how unobtrusive physiological monitoring can provide useful information for understanding the challenges faced by surgeons. “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,” explains Prof. Shimomura.
Looking ahead, the researchers also see this approach as a way to better understand the surgical workplace itself, not just surgeons. “Beyond individual case review, surgeon-state measures could serve as an outcome for evaluating the robotic surgery work system, including console ergonomics, communication routines, workload distribution, procedure-specific difficulty, and training stage. This is the most immediate practical application of the present approach,” remarks Prof. Shimomura.
Future studies involving more hospitals and additional surgical specialties could help determine how these measurements may support human-centered surgical technology and healthier working environments for healthcare professionals. “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 well-being. 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,” concludes Prof. Shimomura.
Source: Chiba University