Spatial cognition in minimally invasive surgery: a systematic review

Abstract

BackgroundSpatial cognition is known to play an important role in minimally invasive surgery (MIS), as it was found to enable faster surgical skill acquisition, reduce surgical time and errors made and significantly improve surgical performance. No prior research attempted to summarize the available literature, to indicate the level of importance of the individual spatial abilities and how they impact surgical performance and skill acquisition in MIS.MethodsPsychological and medical databases were systematically searched to identify studies directly exploring spatial cognition in MIS learning and performance outcomes. Articles written in the English language articles, published between 2006 and 2016, investigating any and all aspect of spatial cognition in direct relation to influence over performance or learning of MIS, were deemed eligible.ResultsA total of 26 studies satisfied this criterion and were included in the review. The studies were very heterogeneous and the vast majority of the participants were novice trainees but with variable degree of skills. There were no clinical studies as almost all studies were conducted on either box trainers or virtual reality simulators. Mental rotation ability was found to have a clear impact on operative performance and mental practice was identified as an effective tool to enhance performance, pre-operatively. Ergonomic set-up of the MIS equipment has a marked influence on MIS performance and learning outcomes.ConclusionsSpatial cognition was found to play an important role in MIS, with mental rotation showing a specific significance. Future research is required to further confirm and quantify these findings in the clinical settings.

Aptitude and attitude: predictors of performance during and after basic laparoscopic skills training

“…With manual dexterity, visual-spatial ability, visual acuity, and stereoacuity found to significantly correlate with laparoscopic training performance [ 13 – 15 , 18 ], participants were assessed on these variables as baseline measures of physical, cognitive, and visual ability in the screening session. The Purdue Pegboard (PP) test (Lafayette Instrument Co) was used to measure innate manual dexterity through four sub-tests: right hand (alone), left hand (alone), bimanual (both hands together), and an assembly task (both hands working simultaneously and continuously to construct assemblies with multiple elements).…”

“…Empirical research has since shown significant correlations of both manual dexterity and visual-spatial ability with novices’ technical performance (i.e. efficiency and accuracy) in laparoscopic skills training [ 10 – 15 ]. While these relationships have not always been observed [ 16 , 17 ], inconsistent and conflicting results may be due to various methodological limitations common in this research field.…”

Spatial adaptation: modeling a key spatial ability

“…Complex spatial reasoning across a diverse range of advanced disciplines, including geology (Jee et al, 2013), surgery (Hegarty, Keehner, Cohen, Montello & Lippa, 2007;Vajsbaher, Schultheis & Francis, 2018), and meteorology (Tricket et al, 2007), appears to often require three key processes: perception, which generates a mental representation from sensory information; spatial transformation, which manipulates and changes that representation (McGee, 1979;Shepard & Metzler, 1971); and comparison, which compares the final representation to one or more possible answers. Here, we introduce a fourth process that we believe is critical for STEM achievement: spatial adaptation, which tailors one's mental representation scheme to a particular task, such that details that are necessary for performing the task are represented, whereas unnecessary details are ignored.…”

Augmenting Surgery: Medical Students’ Assessment and Ergonomics of 3D Holograms vs. CT Scans for Pre-Operative Planning

“…For example, the surgeon could use such 3D models of the patient's organs to assess tumor location and extension, to identify portion of tissue to be removed, to select the correct trajectories to place implants [11], [12] etc. Moreover, from a cognitive point of view, 3D holographic models offer professionals and learners an invaluable support in spatial imagination and mental rotation, cognitive abilities individuals could be more or less skilled in and that notably affect the effectiveness of surgery planning [11,13,14].…”