Francis Sutherland, MD; Elijah Dixon, MD
Bile duct injuries often occur because of surgeon spatial disorientation. The psychological concept of cognitive map misplacement is a useful explanation of how this disorientation and injury occurs. Surgeons may find that using a “bile duct time out” is a helpful way to orient. Based on the mnemonic B-SAFE, they can use 5 subhepatic landmarks (B, bile duct; S, sulcus of Rouviere; A, hepatic artery; F, umbilical fissure; E, enteric/duodenum) to correctly place their cognitive map.
Accepted May 18, 2017
Affiliations: From the Department of Surgery, University of Calgary, Calgary, Alta.
Competing interests: None declared.
Contributors: Both authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication.
Correspondence to: F. Sutherland, Foothills Hospital, 1403 29th St NW, Calgary AB T2N 2T9; email@example.com