Physical and mental stress assessment during robotic-arm assisted total knee arthroplasty

Robotic assistance in total knee arthroplasty (TKA) improves surgical precision but may alter intraoperative stress and workload among staff. This study evaluated these effects in 60 robot-assisted procedures involving surgeons, scrub technicians, circulators, and technicians. Preoperative stress was assessed using the STAI-6, intraoperative stress via heart rate, and postoperative workload, satisfaction, confidence, and team interaction through questionnaires. Preoperatively, most staff reported no anxiety, though newly introduced members showed severe anxiety in up to 15% of cases. Intraoperatively, stress patterns varied by role: surgeons peaked during implantation, scrub technicians and circulators during non-robotic phases, and technicians during robotic-specific steps, especially ligament balancing. The robotic arm did not increase surgeon stress but redistributed workload, reducing physical demands for scrub staff and circulators while raising responsibility for technicians. Postoperatively, satisfaction and confidence were high across groups, though scrub technicians reported the greatest workload from added robotic tasks. Robotic systems guided by dedicated professional personnel have the potential to reduce the intraoperative stress level of the whole surgical team, although it adds multiple additional steps to the traditional workflow.