Abstract: During laparoscopic hepatectomy, surgeons encounter considerable spatial cognitive difficulties due to monitor‑based visualization, the fulcrum effect of surgical instruments, and the complex architecture of hepatic vasculature. As a result, the intrinsic spatial ability of the surgeon is gaining heightened clinical importance. Grounded in cognitive psychology, the authors examine the core elements of spatial perception required for laparoscopic hepatectomy and introduce a systematic framework that combines endogenous cognitive training with exogenous technological support. Additionally, specific methods to alleviate spatial cognitive load during surgery are outlined, with the aims to guide the design of spatial perception training within the advancing field of surgical intelligence.