Trial reportBMC medical education2026
Impact of a full clinical workday on surgical performance in simulated laparoscopy: a controlled crossover trial.
Trial report in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundLaparoscopic surgery places musculoskeletal demands on surgeons, which may be exacerbated by daily clinical activity. The effect of a workday on simulated laparoscopic performance and musculoskeletal parameters remains poorly understood.
objectiveTo assess the impact of a clinical workday on simulated laparoscopic performance, muscle activation, postural control, and perceived workload.
methodsIn this randomized controlled crossover study, 29 gynecologic surgeons (16 novices, 13 experts) performed a standardized suturing and knot-tying task on a pelvic simulator during two sessions: morning before clinical duties and evening after a full workday. Surface electromyography assessed muscle activation, and a force platform measured center-of-pressure parameters during the task. Participants completed questionnaires on fatigue, shoulder tension, effort, and workload (NASA-TLX, SURG-TLX).
resultsSuturing performance was similar between sessions (698 ± 203 vs 683 ± 212 s; p = 0.54). Participants reported higher perceived effort (p < 0.005), fatigue (p < 0.001), and dominant-shoulder tension (p = 0.019) after the workday. NASA-TLX scores remained unchanged, but SURG-TLX showed a trend toward higher mental demand (p = 0.051) and a significant increase in distraction (p = 0.014). Postural analysis revealed reduced antero-posterior center-of-pressure velocity after the workday (p = 0.017).
conclusionA clinical workday does not impair technical laparoscopic performance but induces increases in perceived workload, shoulder tension, and postural adaptations during simulated suturing. These findings highlight the hidden ergonomic cost of daily gynecologic surgical activity and support ergonomic training and workload management strategies in minimally invasive gynecology.
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