Differences in mental workload between traditional and single-incision laparoscopic procedures measured with a secondary task

Am J Surg. 2017 Feb;213(2):244-248. doi: 10.1016/j.amjsurg.2016.09.056. Epub 2016 Oct 8.


Intro: The mental workload associated with laparoscopic suturing can be assessed with a secondary task that requires the same visual-spatial attentional resources. The purpose of this study was to use a secondary task to measure the incremental workload demands of single-incision laparoscopic surgery (SILS) procedures versus traditional laparoscopic procedures.

Method: 12 surgery residents and surgical assistants who had met FLS criteria on an FLS and SILS simulator performed one trial each of peg transfer, cutting, and intracorporeal suturing tasks simultaneously with the secondary task and provided subjective workload ratings using the NASA-TLX.

Results: SILS procedures resulted in lower primary and secondary task scores, p < 0.001 and higher workload ratings, p < 0.0001. Suturing resulted in lower primary (p < 0.003) and secondary task scores (p < 0.017) and higher workload ratings (p < 0.017) compared to the other tasks.

Conclusions: SILS procedures were significantly more mentally demanding than traditional laparoscopic procedures corroborated by primary and secondary tasks scores and subjective ratings.

Keywords: Laparoscopy; Mental workload; Secondary task; Single incision surgery; Skill.

MeSH terms

  • Attention*
  • Clinical Competence
  • Cognition*
  • Humans
  • Laparoscopy / education*
  • Laparoscopy / methods*
  • Simulation Training
  • Task Performance and Analysis*
  • Workload*