The importance of cognitive map placement in bile duct injuries

The importance of cognitive map placement in bile duct injuries

Can J Surg 2017;60(6):424-425 | PDF

Francis Sutherland, MD; Elijah Dixon, MD

Summary

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.

DOI: 10.1503/cjs.008816

Correspondence to: F. Sutherland, Foothills Hospital, 1403 29th St NW, Calgary AB T2N 2T9; francis.sutherland@albertahealthservices.ca