A study to compare the pain, discomfort and tiredness between straight stick and single-incision laparoscopic surgery: an in vitro study

This study compares pain and tiredness experienced by a student and gynaecological surgeons of varying experience between straight sticks (SS) and single-incision laparoscopic surgery (SILS) in vitro. Data was collected prospectively with randomization of the mode sequence. Participants from two hospitals performed identical exercise of cutting circles using SS and SILS in vitro. Questionnaires (Borg CR10 scale scores) were completed at 0, 30 and 60 min, respectively. Wilcoxon’s signed ranked tests were performed on matched pairs of SS and SILS on the number of circles cut and the mistakes between 0–30 and 30–60 min, respectively. There were significant differences between the two groups at 30 min in arm discomfort, hand and finger discomfort, shoulder girdle tiredness, arm tiredness and most significantly in wrist discomfort with a matched median difference of 1.83, confidence interval (CI) 1.00 to 2.67 and P = 0.003. At 60 min, the significant differences between the two groups were in shoulder girdle pain, arm discomfort, hand and finger discomfort, neck tiredness, wrist tiredness, and hand and finger tiredness and the most significant was wrist discomfort with a matched median difference of 1.75, CI 0.50 to 3.25 and P = 0.011. SS causes less tiredness and discomfort in an in vitro setting than with SILS.