Assessing cognitive & motor performance in minimally invasive surgery (MIS) for training & tool design

Area of Science:

• Surgical Simulation and Modeling
• Minimally Invasive Surgery (MIS)
• Human Factors in Surgery

Background:

• Current methods for representing surgical procedures often fail to integrate both cognitive and motor aspects.
• Understanding the interplay between cognitive load and motor execution is crucial for surgical training and performance analysis.
• Task analysis techniques provide a foundation for dissecting complex surgical workflows.

Purpose of the Study:

• To develop and validate a novel modelling diagram, the Minimally Invasive Surgery Cognitive-Motor Diagram (MCMD).
• To represent minimally invasive surgery (MIS) procedures by encompassing both cognitive and motor actions.
• To establish a unified framework for analyzing surgical performance in context.

Main Methods:

• Observation and analysis of laparoscopic cholecystectomy procedures.
• Application of task analysis techniques to develop a diagram language with six primary symbols (processes, decisions, ISRs, options points, AND/OR gates).
• Iterative refinement and testing of the MCMD during 10 new surgical cases and subsequent application to 6 laparoscopic colorectal surgeries.

Main Results:

• The developed MCMD successfully represents both cognitive and motor performance aspects of surgical procedures.
• The diagram language proved robust, requiring no additional symbols across different MIS procedures (cholecystectomy and colorectal surgery).
• The MCMD provides a unified framework for representing complex surgical tasks.

Conclusions:

• The MCMD offers a novel and effective method for modelling MIS procedures, integrating cognitive and motor elements.
• This diagram facilitates future assessment of motor performance within specific surgical contexts.
• The MCMD has the potential to enhance surgical training, simulation, and performance evaluation.