Cognitive load in 3d and 2d minimally invasive colorectal surgery

Area of Science:

• Minimally Invasive Surgery
• Surgical Technology
• Human Factors in Medicine

Background:

• Three-dimensional (3D) laparoscopy offers enhanced depth perception for surgical procedures.
• This study aimed to evaluate the cognitive load experienced by surgeons during 3D versus 2D laparoscopic operations.

Purpose of the Study:

• To compare the cognitive load and perioperative outcomes between 3D and 2D laparoscopic colorectal resections.
• To assess surgeon-reported discomfort and performance metrics in both 3D and 2D laparoscopic settings.

Main Methods:

• Prospective data collection using the Simulator Sickness Questionnaire (SSQ) and NASA task load index (NASA TLX).
• Analysis of perioperative results, including operative time, complications, hospitalization, and reoperation rates.
• Inclusion of 313 patients undergoing either 2D (n=82) or 3D (n=231) laparoscopic colorectal surgery.

Main Results:

• NASA TLX scores showed no significant difference in cognitive load between 3D and 2D groups.
• SSQ results indicated better general discomfort in the 3D group, but more frequent difficulty concentrating, focusing, and fatigue (p=0.001-0.038).
• No significant differences were observed in operative time, severe complications, hospitalization duration, or reoperation rates between the 2D and 3D groups.

Conclusions:

• 3D laparoscopy does not significantly increase overall cognitive load compared to 2D, based on NASA TLX.
• While general discomfort was lower with 3D, some specific cognitive challenges like fatigue were more prevalent.
• 3D laparoscopic surgery demonstrated comparable perioperative outcomes to standard 2D laparoscopy.