(I-617) Intra-operative Stress in Spine Surgery: A Quantitative Biometric Assessment of a Resident Neurosurgeon and the Role of Robotic-assisted Surgery in Decreasing Physiological Stress
Introduction: Spine surgeons face extended hours of increased stress on their bodies, and increasingly complex and longer cases are presenting themselves to the current surgeon workforce. Healthcare worker stress has become an important topic in light of the pandemic, yet there is a paucity of analysis of the physiological effect of already existing job duties of physicians, including surgery. Neurosurgeons have taken a considerable lead in early adoption of robot-assisted spine surgery, allowing the decreased need of lead-aprons. Here, we evaluate the stress response of spinal surgeries on a neurosurgery resident and differences in these responses when performing robot-assisted spine surgery.
Methods: Stress-relevant cardiac parameters (heart rate [HR]) and energy expenditure (calories) were measured during cervical and lumbar fusion surgeries, including those in which a lead-apron were worn and those in which a robot was used. A heart rate monitor was worn at all times during surgery and during the day to obtain baseline averages. Data was transferred to a third party software for analysis.
Results: Average baseline heart rate of participant over 24-hour periods was 51 beats-per-minute (bpm). One- and two-level anterior cervical procedures demonstrated an increase in HR by an average of 30.4 b.p.m (161% over baseline) and an average of 342 calories burned. One and two-level posterior thoracic or lumbar fusions demonstrated an increase in HR by an average of 29.8 b.p.m (160% over baseline). Procedures in which a lead-apron was worn caused a HR increase of 40 b.p.m (180% over baseline) and an average expenditure of 536 calories. Robot-assisted one-level posterior lumbar fusions demonstrated an equal variation of heart rate changes to standard lumbar fusion, however, robot-assisted lumbar cases allowed for decreased energy expenditure compared to non-robot-assisted (582 calories v. 632 calories).
Conclusion : Spine surgery causes a significant stress on the operator, with heart rate changes and calories burned compared to moderate exercise. Lead-aprons compound this effect. Robot-assisted surgery may play a pivotal role in decreasing the physiological toll on the operator, and may allow for more optimal patient outcome. This study is ongoing to include more biometric data (heart-rate variability, etc) from residents and attendings.
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