Trial reportSurgical endoscopy2016
Impact of single-incision laparoscopic cholecystectomy (SILC) versus conventional laparoscopic cholecystectomy (CLC) procedures on surgeon stress and workload: a randomized controlled trial.
Trial report in Surgical endoscopy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Advances in objective assessment of ergonomics in endoscopic surgery: a review.Frontiers in public health · 2023Pooled it
- Laparoscopic surgery and robotic surgery for single-incision cholecystectomy: an updated systematic review.Updates in surgery · 2021Pooled it
- The effect of preferred music on mental workload and laparoscopic surgical performance in a simulated setting (OPTIMISE): a randomized controlled crossover study.Surgical endoscopy · 2021Trial
- Randomized controlled trial of single incision versus conventional multiport laparoscopic cholecystectomy with long-term follow-up.Langenbeck's archives of surgery · 2020Trial
- Clinicians' Stress Levels During Soft Tissue Augmentation Using Autogenous Connective Tissue Grafts: A Pilot Study.Clinical implant dentistry and related research · 2026Article
- Surgeons' physiological parameters and surgical performance: a systematic scoping review.Patient safety in surgery · 2025Review
- Evolution of minimally invasive cholecystectomy: a narrative review.BMC surgery · 2024Review
- Surgeon stress, anxiety, and workload: a descriptive study of participant reported responses to fundamentals of laparoscopic surgery exercises.Surgical endoscopy · 2024Article
- Article
- A systematic review of biological changes in surgeons' acute stress levels during surgery.Surgery in practice and science · 2023Review
- Non-Technical Skill Assessment and Mental Load Evaluation in Robot-Assisted Minimally Invasive Surgery.Sensors (Basel, Switzerland) · 2021Review
- Workload Differentiates Breast Surgical Procedures: NSM Associated with Higher Workload Demand than SSM.Annals of surgical oncology · 2020Observational
- Early experience and learning curve of solo single-incision distal gastrectomy for gastric cancer: a review of consecutive 100 cases.Surgical endoscopy · 2019Article
- Operating hurts: a study of EAES surgeons.Surgical endoscopy · 2019Article
- Wearables in Medicine.Advanced materials (Deerfield Beach, Fla.) · 2018Article
- The effect of multitasking on the communication skill and clinical skills of medical students.BMC medical education · 2018Article
- Intraoperative workload in robotic surgery assessed by wearable motion tracking sensors and questionnaires.Surgical endoscopy · 2017Article
- Quantifying Intraoperative Workloads Across the Surgical Team Roles: Room for Better Balance?World journal of surgery · 2016Article
- Cosmesis and Patient Satisfaction Following Laparoscopic Adnexal Surgery.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.