Cognitive Digital Twins in Surgery: Insights from an International Multidisciplinary Workshop

A multidisciplinary workshop, 'Toward Cognitive Digital Twins in Surgery,' was held during the Hamlyn Symposium in London, UK on Friday, June 27, 2025. This work summarizes the main insights that emerged from the discussion, including the potential benefits and limitations of Cognitive Digital Twins (CogDT) in surgery. The CogDT framework is designed to capture the entire clinical system, including patients and healthcare providers. We introduce the novel concept of the Surgical Cognitive Digital Twin (S-CogDT), highlighting its potential for advancement in surgical care. The primary identified benefits of S-CogDTs include creating dynamic, individualized profiles for personalized provider training, establishing real-time early-warning systems to detect and mitigate surgeon cognitive overload, and streamlining organizational performance within the surgical environment. However, the effective adoption of this technology faces significant challenges. These include the difficulty of measuring and validating dynamic cognitive states, the considerable hurdles in achieving user acceptance and trust, and critical questions surrounding data governance, privacy, and regulatory pathways. These results inform future research in this novel, multidisciplinary field by clearly showing the potential of S-CogDTs and mapping the potential challenges required for their successful implementation.