Trial reportSurgical endoscopy2020
Impact of robotic assistance on mental workload and cognitive performance of surgical trainees performing a complex minimally invasive suturing task.
Trial report in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Measures of performance and proficiency in robotic assisted surgery: a systematic review.Journal of robotic surgery · 2024Pooled it
- Instructional Design for Surgical Novices Based on Cognitive Load Theory: Implications for Urologic Surgery Training.International journal of urology : official journal of the Japanese Urological Association · 2026Review
- General surgery residents have better technical skills and less stress performing complex drills in open fashion over robotic approach.Surgical endoscopy · 2025Article
- Neural insights on expert surgeons' mental workload during live robotic surgeries.Scientific reports · 2025Article
- Cognitive ergonomics and robotic surgery.Journal of robotic surgery · 2024Review
- Residents perform better technically, have less stress and workload, and prefer robotic to laparoscopic technique during inanimate simulation.Surgical endoscopy · 2023Article
- Validation and effect of the NASA-TLX score on the assessment of the workload of pediatric robotic operations.Surgical endoscopy · 2023Article
- Article
- Non-Technical Skill Assessment and Mental Load Evaluation in Robot-Assisted Minimally Invasive Surgery.Sensors (Basel, Switzerland) · 2021Review
- Cognitive Load in Electromagnetic Navigational and Robotic Bronchoscopy for Pulmonary Nodules.ATS scholar · 2020Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFew studies have investigated the potential impact of robotic assistance on cognitive ergonomics during advanced minimally invasive surgery. The purpose of this study was to assess the impact of robotic assistance on mental workload and downstream cognitive performance in surgical trainees.
methodsRobot-naïve trainees from general surgery, urology and gynaecology, stratified by specialty and level of training, were randomised to either laparoscopic surgery (LS) or robotic-assisted laparoscopic surgery (RALS) and performed a time-limited, complex laparoscopic suturing task after watching a 5-min instructional video. The RALS group received an additional 5-min orientation to the robotic console. Subjective mental workload was measured using NASA Task Load Index. Concentration and executive cognitive function were assessed using Psychomotor Vigilance Task (PVT) and Wisconsin Card Sorting Test (WCST), respectively. A p value of 0.05 was considered significant.
resultsSixteen senior residents (SR; ≥ PGY3) and 14 junior residents (JR; PGY1-2) completed the study. There was no difference in mental workload between LS and RALS. Within JR there was no difference in task completion time comparing LS versus RALS; however, LS was associated with impaired concentration post-task versus pre-task (PVT reaction time 306 versus 324 ms, p = 0.03), which was not observed for RALS. In contrast, amongst SR, RALS took significantly longer than LS (10.3 vs. 14.5 min, p = 0.02) and was associated with significantly worse performance on WCST (p < 0.01).
conclusionsRobotic assistance, in this setting, did not provide a technical performance advantage nor impact subjective mental workload with novice users regardless of level of surgery training. We observed a protective effect on cognitive performance offered by RALS to junior trainees with limited LS experience, yet a detrimental effect on senior trainees with greater LS ability and inadequate pre-study robotic training, suggesting that robotic consoles may be mentally taxing for robotic novices and consideration should be given to formal console training prior to initial clinical exposure.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.