SENSE: Surgical ENvironment Stress Evaluation
Research type
Research Study
Full title
The SENSE study: Surgical ENvironment Stress Evaluation. Utilising brain fNIRS to evaluate cognitive and physical stress in surgical leads during conventional and robotic arthroplasty.
IRAS ID
359293
Contact name
Fares S Haddad
Contact email
Sponsor organisation
University College London Hospital NHS Foundation Trust
Duration of Study in the UK
4 years, 11 months, 1 days
Research summary
Surgical procedures such as total hip and knee arthroplasty require a complex set of physical and cognitive skills, expert execution, and inevitably place a high stress load on the surgeon. While the primary focus of healthcare is typically aimed at the patient, the high physical and mental stress placed on surgeons is of equal significance and should be addressed in order to support surgical teams. Robot-assisted surgery is purported to improve surgical outcomes for both patients and surgeons, particularly by improving surgical efficiency and reducing physical and cognitive load on the surgeon. This stress load typically requires a combination gross and fine motor skills, physical exertion, spatial cognition, executive functioning, inhibitory-control, decision-making, communication and team management. Robotic assistance can reduce some of the cognitive load experienced during these processes, although it is also likely to be replaced by new thought-processes.
Therefore, robot-assisted surgery provides a high potential for improving surgical efficiency, and reducing cognitive and physical stress on the surgeon, but the specificity of such processes is less clear. Understanding if, and how, robotic surgery reduces cognitive and physical load could help optimise workflow and aid the design of effective training programmes, with high potential for further improvements in surgical outcomes and supporting surgeon health.
The project will implement wearable brain imaging (functional near-infrared spectroscopy; fNIRS) to track the brain activity of surgeons while performing equivalent tasks during three types of surgery: total hip arthroplasty (THA), total knee arthroplasty (TKA) and partial knee arthroplasty (PKA). We will collect the fNIRS brain imaging alongside physiological markers of stress (e.g. heart rate variability, breathing rate, accelerometry) and potentially also continuous biomarker monitoring (e.g., glucose, cortisol). As part of the data analysis we plan to develop innovative approaches to data integration of: cognitive load, neural haemodynamics, physical strain and physiological stress.REC name
Wales REC 3
REC reference
26/WA/0070
Date of REC Opinion
24 Mar 2026
REC opinion
Further Information Favourable Opinion