Surgical endoscopy · 2025
Impact of intestinal blood flow assessment with indocyanine green fluorescence method and fluorescent ureteral navigation on surgeons' mental workload during laparoscopic colorectal surgery.
СтатьяНазвание и аннотация: Перевод в очереди
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Nakashima Shunsuke, Ryu Shunjin, Imaizumi Yuta, Kawakubo Hyuga, Suzuki Daiki, Kawai Hironari, Kobayashi Takehiro, Goto Keisuke, Okamoto Atsuko, Kamada Teppei, Takahashi Junji, Kobayashi Yasunobu, Takano Yasuhiro, Takeda Yasuhiro, Ito Ryusuke, Eto Ken
Аннотация
BACKGROUND: Anastomotic leakage and ureteral injury are serious complications in colorectal surgery, negatively impacting both short- and long-term outcomes. Indocyanine green (ICG) fluorescence has gained attention for intraoperative intestinal perfusion assessment and ureteral navigation. This study evaluated whether these ICG fluorescence-based techniques reduce surgeons' mental workload.
METHODS: We retrospectively assessed surgeons' workload using the NASA Task Load Index (TLX) during laparoscopic colorectal surgeries performed between January and December 2022. Anastomotic blood flow was assessed either using the ICG fluorescence method (n = 158) or the conventional method (n = 29). Moreover, patients undergoing left-sided colorectal surgery were divided into two groups based on the use of fluorescent ureteral navigation (n = 29) versus nonfluorescent navigation (n = 72).
RESULTS: Surgeons using ICG fluorescence for blood flow assessment reported significantly lower TLX scores across all domains, including weighted workload (WWL): 12.3 (IQR: 10.5-17.3) vs. 46.8 (IQR: 21.6-54.4), P < 0.0001. Similarly, fluorescent ureteral navigation was associated with significantly lower frustration (20 [12.5-35] vs. 30 [20-55], P = 0.0093) and WWL (20.3 [17.2-36.5] vs. 29 [19.0-43.9], P = 0.0412) compared with the nonfluorescent group. Among surgeons not certified by the Japan Society for Endoscopic Surgery, fluorescent guidance resulted in lower frustration and WWL (P = 0.0053 and P = 0.0092, respectively). No significant differences were observed among certified surgeon.
CONCLUSION: ICG fluorescence-based techniques for anastomotic perfusion and ureteral navigation effectively reduce mental workload for surgeons, especially for those without endoscopic surgical certification. These methods may serve as supportive tools in promoting safe and ergonomic colorectal surgery.
METHODS: We retrospectively assessed surgeons' workload using the NASA Task Load Index (TLX) during laparoscopic colorectal surgeries performed between January and December 2022. Anastomotic blood flow was assessed either using the ICG fluorescence method (n = 158) or the conventional method (n = 29). Moreover, patients undergoing left-sided colorectal surgery were divided into two groups based on the use of fluorescent ureteral navigation (n = 29) versus nonfluorescent navigation (n = 72).
RESULTS: Surgeons using ICG fluorescence for blood flow assessment reported significantly lower TLX scores across all domains, including weighted workload (WWL): 12.3 (IQR: 10.5-17.3) vs. 46.8 (IQR: 21.6-54.4), P < 0.0001. Similarly, fluorescent ureteral navigation was associated with significantly lower frustration (20 [12.5-35] vs. 30 [20-55], P = 0.0093) and WWL (20.3 [17.2-36.5] vs. 29 [19.0-43.9], P = 0.0412) compared with the nonfluorescent group. Among surgeons not certified by the Japan Society for Endoscopic Surgery, fluorescent guidance resulted in lower frustration and WWL (P = 0.0053 and P = 0.0092, respectively). No significant differences were observed among certified surgeon.
CONCLUSION: ICG fluorescence-based techniques for anastomotic perfusion and ureteral navigation effectively reduce mental workload for surgeons, especially for those without endoscopic surgical certification. These methods may serve as supportive tools in promoting safe and ergonomic colorectal surgery.