Studying Brain Activation during Skill Acquisition via Robot-Assisted Surgery Training.

Area of Science:

• Neurosurgery and Medical Simulation
• Cognitive Neuroscience in Surgical Training

Background:

• Robot-assisted surgery (RAS) systems offer significant advantages in minimally invasive procedures, enhancing visualization, precision, and patient recovery.
• High-fidelity simulators are crucial for training surgeons on RAS systems, driving demand for effective simulation-based education.
• Understanding the cognitive processes during skill acquisition in RAS is vital for optimizing training protocols.

Purpose of the Study:

• To investigate changes in brain activity during the skill acquisition of resident surgeons using robot-assisted surgery simulators.
• To measure hemodynamic changes in the prefrontal cortex using functional near-infrared spectroscopy (fNIRS) during RAS simulator training.

Main Methods:

• Twenty-four resident medical doctors participated in RAS simulator training.
• Participants completed sponge suturing tasks at three difficulty levels across two consecutive sessions (Block 1 and Block 2).
• Functional near-infrared spectroscopy (fNIRS) was used to monitor hemodynamic responses in the prefrontal cortex.

Main Results:

• Cortical oxygenation changes in the prefrontal cortex were significantly lower in the second training session (Block 2) compared to the initial session (Block 1).
• This reduction in prefrontal cortex activity suggests improved neural efficiency and skill consolidation during RAS training.
• The findings indicate a measurable neurophysiological correlate of skill acquisition in robot-assisted surgery.

Conclusions:

• Skill acquisition in robot-assisted surgery training is associated with decreased cognitive load, reflected by reduced prefrontal cortex activity.
• Functional near-infrared spectroscopy (fNIRS) is a viable tool for assessing cognitive changes during surgical simulator training.
• These findings support the effectiveness of RAS simulators in developing surgical expertise and can inform future training program development.