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Robotic surgery improves technical performance and enhances prefrontal activation during high temporal demand

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Title: Robotic surgery improves technical performance and enhances prefrontal activation during high temporal demand
Authors: Singh, H
Modi, HN
Ranjan, S
Dilley, J
Airantzis, D
Yang, G
Darzi, A
Leff, D
Item Type: Journal Article
Abstract: Robotic surgery may improve technical performance and reduce mental demands compared to laparoscopic surgery. However, no studies have directly compared the impact of robotic and laparoscopic techniques on surgeons’ brain function. This study aimed to assess the effect of the operative platform (robotic surgery or conventional laparoscopy) on prefrontal cortical activation during a suturing task performed under temporal demand. Eight surgeons (mean age ± SD = 34.5 ± 2.9 years, male:female ratio = 7:1) performed an intracorporeal suturing task in a self-paced manner and under a 2 min time restriction using conventional laparoscopic and robotic techniques. Prefrontal activation was assessed using near-infrared spectroscopy, subjective workload was captured using SURG-TLX questionnaires, and a continuous heart rate monitor measured systemic stress responses. Task progression scores (au), error scores (au), leak volumes (mL) and knot tensile strengths (N) provided objective assessment of technical performance. Under time pressure, robotic suturing led to improved technical performance (median task progression score: laparoscopic suturing = 4.5 vs. robotic suturing = 5.0; z = − 2.107, p = 0.035; median error score: laparoscopic suturing = 3.0 mm vs. robotic suturing = 2.1 mm; z = − 2.488, p = 0.013). Compared to laparoscopic suturing, greater prefrontal activation was identified in seven channels located primarily in lateral prefrontal regions. These results suggest that robotic surgery improves performance during high workload conditions and is associated with enhanced activation in regions of attention, concentration and task engagement.
Issue Date: 1-Oct-2018
Date of Acceptance: 10-May-2018
URI: http://hdl.handle.net/10044/1/60818
DOI: 10.1007/s10439-018-2049-z
ISSN: 0090-6964
Publisher: Springer Verlag
Start Page: 1621
End Page: 1636
Journal / Book Title: Annals of Biomedical Engineering
Volume: 46
Issue: 10
Copyright Statement: © The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Sponsor/Funder: National Institute of Health Research
Keywords: Science & Technology
Technology
Engineering, Biomedical
Engineering
Neuroimaging
Brain function
Stress
Cognitive workload
Surgical skills
Laparoscopy
Suturing
NEAR-INFRARED SPECTROSCOPY
NERVOUS-SYSTEM
BRAIN
SKILLS
WORKLOAD
CORTEX
TASK
STANDARD
HUMANS
FNIRS
Brain function
Cognitive workload
Laparoscopy
Neuroimaging
Stress
Surgical skills
Suturing
Adult
Attention
Brain Waves
Female
Humans
Laparoscopy
Male
Prefrontal Cortex
Robotic Surgical Procedures
Prefrontal Cortex
Humans
Laparoscopy
Attention
Adult
Female
Male
Brain Waves
Robotic Surgical Procedures
Biomedical Engineering
11 Medical and Health Sciences
09 Engineering
Publication Status: Published
Online Publication Date: 2018-06-04
Appears in Collections:Faculty of Engineering
Division of Surgery
Computing
Faculty of Medicine



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