The objective of this study is to analyze noise patterns during 599 visceral surgical procedures. considering work-safety regulations, we will identify immanent noise patterns during major visceral surgeries. Increased levels of noise are known to have negative health impacts. Based on a very finegrained data collection over a year, this study will introduce a new procedure for visual representation of intra-surgery noise progression and pave new paths for future research on noise reduction in visceral surgery. Digital decibel sound-level meters were used to record the total noise in three operating theatres in one-second cycles over a year. these data were matched to archival data on surgery characteristics. Because surgeries inherently vary in length, we developed a new procedure to normalize surgery times to run cross-surgery comparisons. Based on this procedure, dBA values were adjusted to each normalized time point. noise-level patterns are presented for surgeries contingent on important surgery characteristics: 16 different surgery types, operation method, day/night time point and operation complexity (complexity levels 1-3). This serves to cover a wide spectrum of day-today surgeries. The noise patterns reveal significant sound level differences of about 1 dBA, with the mostcommon noise level being spread between 55 and 60 dBA. This indicates a sound situation in many of the surgeries studied likely to cause stress in patients and staff. Absolute and relative risks of meeting or exceeding 60 dBA differ considerably across operation types. In conclusion, the study reveals that maximum noise levels of 55 dBA are frequently exceeded during visceral surgical procedures. Especially complex surgeries show, on average, a higher noise exposure. Our findings warrant active noise management for visceral surgery to reduce potential negative impacts of noise on surgical performance and outcome. Surgeons, nurses and patients-during some procedures-are exposed to high noise levels. Noise is defined by work-safety regulations as a sound that may have a negative impact on health (e.g. impairment of hearing ability). Previous research demonstrates that the use of surgical instruments may result in significant noise exposure up to a level of 131 dBA for both staff and patient 1-3. Existing research also shows that exposure to noise can increase an operating surgeon's blood-based cortisol level, result in irreversible hearing loss or cause cardiovascular diseases 4-7. The negative impact of noise is not limited to direct effects on staff and patient health but also affects the patient indirectly by lowering the quality of the surgeon's work. Specifically, research demonstrates that intraoperative noise, among other factors, impairs the mental concentration of the operating team, eventually resulting in postoperative complications (e.g. infections) 8-11. While research on noise in the operating theatre is a mature research area, existing literature continues to lack comprehensive empirical evidence of noise pollution during v...

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