European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie
September 22, 2026 · via Europe PMC
Stress Exposure of Camera-Holders Versus Primary Surgeons During Laparoscopic Surgery: Best Evidence Analysis.
Wiernik A, Garnier H, Dagilyte RV, Oster AC, Brauner P, Saxena AK.
AI summary — for doctors, generated from the abstract only
Camera-holders in laparoscopic surgery face meaningful but different stressors than primary surgeons, especially ergonomic strain and poor viewing angles.
What was studied
A PRISMA best-evidence review of seven heterogeneous studies (2000-2025) comparing stress in camera-holders and primary surgeons; only one pediatric study.
Key findings
- Primary surgeons reported higher subjective cognitive workload
- EEG suggested comparable cognitive engagement
- Camera-holders had greater trapezius activation, asymmetric loading, and non-neutral posture
- One large study found more fatigue and psychosocial stress among camera-holders
Clinical relevance
This suggests attention to camera-holder ergonomics and team communication, though evidence is sparse and mostly adult.
Who should care
Limitations
Only seven heterogeneous studies, narrative synthesis, minimal pediatric data.
Holding the camera is a demanding role that deserves ergonomic attention.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
To evaluate and compare stress exposure between camera-holders (CHs) and primary surgeons (PSs) during laparoscopic surgery across cognitive, physiological, ergonomic, fatigue-related and psychosocial domains.
Methods
A best evidence review was conducted according to PRISMA guidelines. PubMed, Web of Science, Cochrane Library, Embase and Scopus were searched for studies published between January 2000 and December 2025. Eligible studies reported objective or subjective stress-related outcomes in CHs and/or PSs during laparoscopic surgery. Methodological quality was assessed using Joanna Briggs Institute critical appraisal tools. Owing to heterogeneity in study designs and outcome measures, findings were synthesized narratively.
Results
Seven heterogeneous studies met the inclusion criteria, with only one study specifically evaluating pediatric procedures. Available evidence suggested role-specific patterns of stress exposure. PSs generally reported higher subjective cognitive workload, whereas EEG-based findings suggested comparable cognitive engagement between PSs and CHs. CH-related ergonomic findings included greater trapezius activation, asymmetric loading, non-neutral posture and less favorable viewing angles. Musculoskeletal discomfort was reported in both roles, while one large cross-sectional study found greater intraoperative fatigue and psychosocial stress related to image control and negative verbal interactions among CHs. The single pediatric study identified less favorable viewing angles and greater procedural discomfort among CHs than PSs.
Conclusion
Available evidence suggests that the CH role is an active and demanding component of laparoscopic surgery, with stressors that differ from those experienced by PSs. However, conclusions are limited by the small number of heterogeneous studies and the predominance of adult data. Pediatric evidence is particularly limited and currently relates mainly to ergonomic outcomes.
DOI
10.1055/a-2965-8071
PMID
42772718
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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