Surgical team workload comparison for 4-port and single-port laparoscopic cholecystectomy procedures

Bethany R. Lowndes, Amro M. Abdelrahman, Cornelius A. Thiels, Amani O. Mohamed, Andrea L. McConico, Juliane Bingener, M. Susan Hallbeck

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Advanced minimally invasive procedures may cause postural constraints and increased workload and stress for providers. This study compared workload and stress across surgical team roles for 48 laparoscopic cholecystectomies (4-port vs single-port)using a task load index (NASA-TLX), a procedural difficulty question, and salivary stress hormones. Statistical analyses were performed based on the presence intra-cluster correlation within team roles, at α=0.05. The single-port technique resulted in an 89% increase in physical workload for the surgeon and 63% increase for the assistant (both p<0.05). The surgeon had significantly higher salivary stress hormones during single-port surgeries. The degree of procedural difficulty was positively correlated between the surgeon and most roles: resident (r=0.67), assistant (r=0.81), and technician (r=0.81). There was a statistically significant positive correlation between the surgeon and assistant for all selfreported workload measures (p<0.05). The single-port technique requires further improvement to balance surgical team workload for optimal patient safety and satisfaction.

Original languageEnglish (US)
Pages (from-to)277-285
Number of pages9
JournalApplied Ergonomics
StatePublished - Jul 2019


  • Laparoscopic Cholecystectomy
  • Surgical Team
  • Workload

ASJC Scopus subject areas

  • Human Factors and Ergonomics
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Safety, Risk, Reliability and Quality
  • Engineering (miscellaneous)


Dive into the research topics of 'Surgical team workload comparison for 4-port and single-port laparoscopic cholecystectomy procedures'. Together they form a unique fingerprint.

Cite this