Neuroenhancement of surgeons during robotic suturing

Area of Science:

• Neurosurgery
• Surgical Education
• Robotic Surgery

Background:

• Robotic surgery is increasingly common, yet early skill acquisition involves technical deficits like low knot-tensile strength (KTS).
• Transcranial direct-current stimulation (tDCS) enhances motor tasks, but its application in robotic surgery training is underexplored.
• Prefrontal cortex (PFC) activation is crucial for early robotic suturing performance.

Purpose of the Study:

• To investigate the efficacy of prefrontal tDCS in improving robotic suturing technical performance.
• To assess the impact of tDCS on knot-tensile strength (KTS) and error scores in surgical residents performing robotic suturing.

Main Methods:

• A double-blind, crossover study involving 15 surgical residents randomized to active or sham tDCS sessions.
• Participants performed robotic suturing tasks in pre-, intra-, and post-stimulation blocks.
• Primary outcomes measured were knot-tensile strength (KTS) and error scores.

Main Results:

• Active tDCS significantly increased knot-tensile strength (KTS) compared to sham stimulation (44.35 N vs. 27.12 N).
• A significant reduction in error scores was observed post-stimulation only in the active tDCS group.
• Faster task completion times were noted longitudinally, irrespective of stimulation type.

Conclusions:

• Prefrontal tDCS can effectively reduce errors and enhance KTS in robotic suturing.
• tDCS represents a potential adjunct for improving robotic surgical training and skill acquisition.
• Further research is warranted to explore tDCS as a tool in surgical education.