ArticleSurgical endoscopy2025
Visual attention and cognitive workload using different laparoscopic box trainers and mixed-reality feedback.
Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- From gaze to proficiency: deep learning-driven prediction of novice performance in laparoscopic training using AOI-dependent metrics.Surgical endoscopy · 2026Article
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLaparoscopic techniques have revolutionized minimally invasive surgery (MIS) but remain visually and mentally demanding, especially in smaller operative sites (e.g., pediatric patients). Though traditional box trainers serve as the golden standard for laparoscopic simulation-based training (SBT), they are limited due to their lack of real-time feedback and objective assessments. Advancements in SBT using Visual Reality (VR) and Augmented/Mixed-Reality (AR/MR) can provide objective real-time evaluations. This study assessed the effects of mixed-reality feedback on trainees' visual attention and mental workload during adult and pediatric laparoscopic SBT.
methodsExpert (n = 4) and novice surgeons (n = 24) were recruited to investigate the effects of various laparoscopic box trainers (e.g., adult and pediatric patients), as well as different feedback conditions in a MR setting, on trainees' visual attention and perceived mental workload. Peg transfer task was chosen to evaluate novices' ambidexterity and eye-hand coordination. Eye-tracking metrics (fixations, fixation durations, saccades, and saccade durations) and mental workload indicators (pupil diameter and NASA-TLX scores) were collected. K-means clustering was used to classify novices into proficiency groups based on these metrics.
resultsEye-tracking and mental workload metrics successfully differentiated two novice proficiency groups, significantly different from expert performance. Analysis revealed two key findings: novices demonstrated shorter fixation durations when using the pediatric trainer when compared to the adult trainer, and pupil diameter was lower for participants who started their trials with pediatric trainers (p = 0.016). However, the presence or absence of mixed-reality feedback did not significantly affect visual attention patterns or mental workload measures.
conclusionsVisual attention and mental workload metrics in mixed-reality environments effectively differentiated novice proficiency levels in laparoscopic box trainers. Our findings validate eye-tracking metrics for objective skill assessment in both adult and pediatric trainers, highlighting their potential for adaptive training programs and competency evaluation in surgical education.
Indexed as
Identifiers
What OpenQuestion holds
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.