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28 April 2019 : Laboratory Research  

Subjective and Objective Quantification of the Effect of Distraction on Physician’s Workload and Performance During Simulated Laparoscopic Surgery

Jiaqi Gao12ACDE, Shenglin Liu12AFG, Qingmin Feng12A, Xutian Zhang12B, Mingyin Jiang12C, Linlin Wang12B, Jianyang Zhang2C, Qiang Zhang12ADEFG*

DOI: 10.12659/MSM.914635

Med Sci Monit 2019; 25:3127-3132

Abstract

BACKGROUND: Distracting interference cognitive tasks place undeniable pressure on the minds of people who need high precision and attention during the tasks, such as those tasks performed during surgery; these tasks might affect current surgical procedures. We measured the effect of additional cognitive tasks on the mental load of the physician by measuring the mean change in pupil size, blink rate, and subjective assessment during surgery.

MATERIAL AND METHODS: We recruited 24 participants with different levels of laparoscopic surgery to perform a complete appendectomy using a standardized virtual reality laparoscopic surgery simulator. The participants then performed the cognitive task (arithmetic problem), after that they performed an appendectomy surgery task while completing the cognitive task on the simulator. All participants wore trackers to monitor pupil size and blink rate during surgery and the cognitive task. The National Aeronautics and Space Administration (NASA) Task Load Index (TLX) score also recorded performance parameters during the surgical mission.

RESULTS: The double-task pupil size and the blink rate were significantly increased compared to the single-task observation, and the associated increase in psychological load might have been affected by surgical performance, and the performance parameters were also statistically significant. However, for the aforementioned parameters, experienced surgeons had some differences compared with inexperienced surgeons, but these differences did not reach statistical significance.

CONCLUSIONS: Distracted cognitive task stimulation in the operating room can increase the surgeon’s psychological burden while also affecting their operational skills, thereby threatening patient safety; reduced cognitive costs might be obtained by improving or managing cognitive deficits.

Keywords: Appendectomy, Eye Movements, Laparoscopy, Workload, Attention, Clinical Competence, Computer Simulation, Eye Movement Measurements, Physicians, Task Performance and Analysis

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750