AB087. SOH26AB_0117. Assessment of cognitive workload associated with indocyanine green fluorescence angiography in colorectal surgery
Colorectal Session I

AB087. SOH26AB_0117. Assessment of cognitive workload associated with indocyanine green fluorescence angiography in colorectal surgery

Philip McEntee1, Rickson Mesquita2, Edward Murphy1, Patrick Boland1, Ronan Cahill1

1Centre for Precision Surgery, University College Dublin, Dublin, Ireland; 2School of Computer Science, University of Birmingham, Birmingham, UK

Background: Intraoperative indocyanine green fluorescence angiography (ICGFA) is associated with lower rates of anastomotic leak in colorectal surgery. This study aimed to evaluate the cognitive workload (CWL) associated with its interpretation, relative to other operative tasks, in both simulated and actual surgery.

Methods: Specialty surgical trainees, fellows, and consultants were recruited with consent. Heart rate variability (HRV) and functional near-infrared spectroscopy (fNIRS) were used as physiological indicators of CWL during both a simulated session [sequentially measuring CWL at baseline, while performing laparoscopic skills, and during operative video interpretation] and in theatre during resectional colorectal surgery (monitoring relative CWL during serial operative steps immediately before and after ICGFA).

Results: A total of 22 participants completed simulation testing, with 11 also providing in-theatre data. The majority had minimal/no ICGFA experience. In simulation testing, linear mixed effects (LME) modelling of the fNIRS data indicated that ICGFA interpretation was not significantly associated with higher CWL versus baseline overall, but this varied by individual, with consultants and non-gastrointestinal (GI) surgeons having significantly lower CWL for ICGFA interpretation (P<0.05). HRV assessment revealed contrasting parameter findings with elevated CWL during laparoscopic skills being the more robust conclusion. In-theatre testing (10 colorectal surgeons) revealed ICGFA interpretation imposed broadly similar CWL to other intraoperative steps, imposing the highest CWL in four individuals by HRV or at least one fNIRS measure, with one measure indicating significantly higher CWL than in simulation.

Conclusions: ICGFA interpretation exhibits broadly similar CWL as other operative steps, in both simulated and in-theatre settings, with important differences evident by test context.

Keywords: Cognitive workload (CWL); colorectal surgery; indocyanine green fluorescence angiography (ICGFA); heart rate variability (HRV); functional near-infrared spectroscopy (fNIRS)

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab087
Cite this abstract as: McEntee P, Mesquita R, Murphy E, Boland P, Cahill R. AB087. SOH26AB_0117. Assessment of cognitive workload associated with indocyanine green fluorescence angiography in colorectal surgery. Mesentery Peritoneum 2026;10:AB087.

Article Options

Download Citation

Share