A multi-modal approach to cognitive training and assistance in minimally invasive surgery

Abstract Minimally-invasive surgery (MIS) offers many benefits to patients, but is considerably more difficult to learn and perform than is open surgery. One main reason for the observed difficulty is attributable to the visuo-spatial challenges that arise in MIS, taxing the surgeons’ cognitive skills. In this contribution, we present a new approach that combines training and assistance as well as the visual and the auditory modality to help surgeons to overcome these challenges. To achieve this, our approach assumes two main components: An adaptive, individualized training component as well as a component that conveys spatial information through sound. The training component (a) specifically targets the visuo-spatial processes crucial for successful MIS performance and (b) trains surgeons in the use of the sound component. The second component is an auditory display based on a psychoacoustic sonification, which reduces and avoids some of the commonly experienced MIS challenges. Implementations of both components are described and their integration is discussed. Our approach and both of its components go beyond the current state of the art in important ways. The training component has been explicitly designed to target MIS-specific visuo-spatial skills and to allow for adaptive testing, promoting individualized learning. The auditory display is conveying spatial information in 3-D space. Our approach is the first that encompasses both training for improved mastery and reduction of cognitive challenges in MIS. This promises better tailoring of surgical skills and assistance to the needs and the capabilities of the surgeons and, thus, ultimately, increased patient safety and health.