• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES Top 21 MIS Procedures
    • SAGES Pearls
    • SAGES Flexible Endoscopy 101
    • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

Quantifying Mental Workload of Surgeons Performing NOTES Procedures

Bin Zheng, MD PhD, Erwin Rieder, MD, Maria A Cassera, BS, Danny V Martinec, BS, Lee L Swanström, MD. Department of Surgery, University of British Columbia, Canada; Minimally Invasive Surgery Program, Legacy Health, Portland, Oregon

INTRODUCTION: During Natural Orifice Transluminal Endoscopic Surgery (NOTES), surgeons often have difficulties orienting the surgical view and manipulating instruments accurately, which increases surgeons’ mental and physical fatigues. Overloaded surgeons may have problems making logical decisions and maintaining dexterity during an operation. Therefore, quantifying surgeons’ mental workload provides an opportunity to understand surgeons’ response to the challenges posed by NOTES, and it is an essential step for developing an effective strategy to ensure safe performance of NOTES procedures. We took initiative to quantify mental workload by measuring spared mental resources of surgeons while performing NOTES training tasks. We hypothesized that surgeons would require more mental resources while performing NOTES procedures than during laparoscopic procedures; thus, leaving less spared mental resources for effective performance of a secondary task.

METHODS: Assessment was conducted in two stages. First, NOTES training tasks were performed in a human mannequin bench-top model, and second, in a hybrid animate model. In the bench-top model, surgeons were required to complete a ring transfer task, passing a ring as many times as possible between two graspers placed through a dual channel endoscope in a time period of 6 minutes. In the hybrid animate model, a pig liver and gall-bladder were placed inside a standard laparoscopic training box. Surgeons were required to dissect the gall-bladder from the liver-bed using cautery and graspers placed through an NOTES operating platform. While performing the NOTES task in either the bench-top or the hybrid model, a secondary visual detection task was introduced to assess mental workload. The surgeon was required to identify 60 true visual signals among 300 false signals that were displayed randomly on an adjacent monitor placed 15 degrees off axis to the surgical monitor. Surgeons were asked to repeat the trials using laparoscopy. Surgeons’ performance of the primary and secondary tasks using both the NOTES and laparoscopic approaches were compared.

RESULTS: Of the 9 surgeons who completed trials in the bench-top model, a mean of 13.0 ± 4.0 rings were successfully transferred between targets using laparoscopy, in contrast to a mean of 1.2 ± 1.0 rings when performing the task using the NOTES platform (P <0.001). While transferring rings by laparoscopy, surgeons were able to detect 74% of true visual signals presented on the side monitor, which is significantly higher than the 54% detection rate when performed using the NOTES platform (P = 0.005). In the hybrid model, 10 surgeons were able to detect 56% of true visual signals displayed on the side monitor while performing the cholecystectomy task. This was found to be significantly higher (P = 0.006) than when the task was performed using the NOTES platform (39%).

CONCLUSION: Results support our hypothesis that performance of a task using the NOTES platform increases surgeons’ mental workload, when compared to task performance using standard laparoscopy. Since difficulty in performing NOTES is associated with flexible endoscopy, we expect that new operating systems providing stable platforms would help to decrease the mental workload of surgeons and enhance the safety in performing NOTES.


Session: SS11
Program Number: S055

103

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2024 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons