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Original research
Silent operating theatre optimisation system for positive impact on surgical staff-members' stress, exhaustion, activity and concentration in urological da Vinci surgeries
  1. Imke Meyer-Lamp1,
  2. Margarete Boos1,
  3. Lisa S Schugmann1,
  4. Conrad Leitsmann2,
  5. Lutz Trojan2,
  6. Martin G Friedrich3
  1. 1 Psychology, University of Göttingen, Göttingen, Germany
  2. 2 Urology, University Medical Center Göttingen, Göttingen, Niedersachsen, Germany
  3. 3 Thoracic and Cardiovascular Surgery, University Medical Center Göttingen, Göttingen, Niedersachsen, Germany
  1. Correspondence to Professor Margarete Boos, Psychology, University of Gottingen, Goettingen, Niedersachsen, Germany; mboos{at}


Background Noise in the operating room (OR) is a stressor with far-reaching negative consequences. The Silent Operating Theatre Optimisation System (SOTOS) suppresses the noise level in the OR and improves the communication of the OR-staff. This study investigates whether SOTOS has a positive impact on the OR-staff’s perceived stress, exhaustion, activity and concentration.

Methods Data were collected in a quasi-experimental study design of 32 radical prostatectomies using the da Vinci robotic-assisted system. Sixteen randomly chosen surgeries were carried out with SOTOS and 16 without. A total of 34 OR-staff-members took part, each 32 surgeries involving five planned OR-staff-members. Two points of measurement, before and after each surgery, were carried out, with a final sample of n=143 repeated measurements data. Before and after surgery, OR-staff-members completed a concentration test and a questionnaire concerning their perceived stress, exhaustion and activity levels.

Results The OR-staff felt significantly less stressed, less exhausted and more active during and after surgery when operating with SOTOS. Especially the primary surgeons, assisting surgeons and circulating nurses profited from SOTOS. SOTOS did not reveal a significant impact on the OR-staff’s concentration in this study.

Conclusion For urological surgeries using the da Vinci system SOTOS constitutes a technical resource which significantly reduces perceived noise stress and exhaustion and improves the activity of primary surgeons, assisting surgeons and circulating nurses. These efficiencies likely lead to positive changes in their health and job satisfaction and are hence beneficial to the patient safety and hospital resources.

  • surgical staff
  • operating theatre
  • noise reduction
  • stress
  • da vinci system

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  • IM-L and MB contributed equally.

  • Contributors The contributorship is as follows: IML – data collection, data analysis and writing of the manuscript. MB – data collection and writing of the manuscript. LSS – data collection and data analysis. CL – data collection and urological expertise. LT – data collection and urological expertise. MGF – invention and administration of SOTOS technical system and writing of the manuscript.

  • Funding The study did not receive external funding. Therefore, the authors are independent from any funders. All authors had full access to the data in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests MGF is the inventor of the SOTOS and all included features. The SOTOS is patented and the patent holder is the University Medical Center Göttingen, Germany (DE102015205463, PCT/EP2016/056659).

  • Patient consent for publication Not required.

  • Ethics approval Ethics approval (DOK_204_2015) for this research was granted by the Ethics Commission of the University Medical Center Göttingen (UMG), Germany, on 17 August 2015.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Please contact the corresponding author for data availability.