Physiological stress during laparoscopic surgery training harms outcomes.

• Heart rates were higher during surgery, peaking with complex procedures like splenectomies.
• Higher heart rate linked to lower laparoscopic performance (r=-0.41, p=0.07).
• However, better performance correlated with higher heart rate variability (sdnn: r=0.56, p=0.008; rmssd: r=0.63, p<0.001).

Minimizing stress can lead to better surgical training outcomes; consider incorporating stress-monitoring tech.