The study demonstrated that, contrary to common belief, proficiency in surgery does not protect against stressful auditory influences or the influence of mental preoccupation. Interestingly, relaxing auditory influences such as classical music can even have a positive impact on the accuracy of experts. Previous musical experience could help to identify surgeons whose performance may be specifically affected by music or noise.

Natural orifice translumenal endoscopic surgery (NOTES) for rectosigmoid resection using TEM with or without transgastric endoscopic assistance is feasible and associated with low morbidity in a porcine survival model. Transgastric assistance significantly prolongs the operative time but extends the length of the rectosigmoid mobilized transanally, with a nonsignificant increase in complication rates related to gastrotomy creation.

OBJECTIVE To explore how the two most important components of surgical performance - speed and accuracy - are influenced by different forms of stress and what the impact of music on these factors is. SUMMARY BACKGROUND DATA Based on a recently published pilot study on surgical experts, we designed an experiment examining the effects of auditory stress, mental stress, and music on surgical performance and learning, and then correlated the data psychometric measures to the role of music in a novice surgeon’s life. METHODS 31 surgeons were recruited for a crossover study. Surgeons were randomized to four simple standardized tasks to be performed on the Surgical SIM VR laparoscopic simulator, allowing exact tracking of speed and accuracy. Tasks were performed under a variety of conditions, including silence, dichotic music (auditory stress), defined classical music (auditory relaxation), and mental loading (mental arithmetic tasks). Tasks were performed twice to test for memory consolidation and to accommodate for baseline variability. Performance was correlated to the Brief Musical Experience Questionnaire (MEQ). RESULTS Mental loading influences performance with respect to accuracy, speed, and recall more negatively than does auditory stress. Defined classical music might lead to minimally worse performance initially, but leads to significantly improved memory consolidation. Furthermore, psychologic testing of the volunteers suggests that surgeons with greater musical commitment, measured by the MEQ, perform worse under the mental loading condition. CONCLUSION Mental distraction and auditory stress negatively affect specific components of surgical learning and performance. If used appropriately, classical music may positively affect surgical memory consolidation. It also may be possible to predict surgeons’ performance and learning under stress through psychological tests on the role of music in a surgeon’s life. Further investigation is necessary to determine the cognitive processes behind these correlations.