Background Intermittent work breaks are common in fields with high workload but not yet for
surgeons during operations. We evaluated the effects of intraoperative breaks during
complex laparoscopic surgery (5 min every half hour) on the surgeon. Methods Fifty-one
operations were randomized to a scheme with intraoperative breaks and release of the
pneumoperitoneum (intermittent pneumoperitoneum (IPP)) or conventional conduct (CPP).
Stress hormones and α-amylase were determined in the surgeon's saliva pre-, intra-, and …

With great interest we read the letter of Rieger et al. on work-related stress. In contrast to the
authors, we did not investigate the effects of lead gowns. The results reported in the letter
illustrate Wickens' classical multi resource theory published in 1991 [1]. It states that one
given task produces demand on various personal resources, including psychological and
physical resources. This is confirmed by the authors of the letter. However, stress is a normal
phenomenon and to some extent desirable. It remains of particular interest whether a stress …