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Comparing Behavioral and Neural Activity Changes During Laparoscopic and Robotic Surgery Trainings.

Mehmet Emin Aksoy1, Kurtulus Izzetoglu2, Nihat Zafer Utkan3

  • 1Department of Biomedical Device Technology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Türkiye; CASE (Center of Advanced Simulation and Education), Acibadem Mehmet Ali Aydinlar University, Istanbul, Türkiye.

Journal of Surgical Education
|March 12, 2025
PubMed
Summary
This summary is machine-generated.

Robotic-assisted surgery (RAS) simulators show lower cognitive workload and improved efficiency compared to laparoscopic simulators in general surgery residents. This suggests RAS may offer a more efficient training environment for surgical skills development.

Keywords:
functional near infrared spectroscopy efficiency indexminimal invasive surgeryrobotic surgerytraining

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Area of Science:

  • Neurosurgery
  • Surgical Education
  • Medical Simulation

Background:

  • Cognitive workload is a critical factor in surgical performance and training.
  • Robotic-assisted surgery (RAS) is increasingly adopted, necessitating effective simulation-based training.
  • Understanding the cognitive demands of different surgical modalities is essential for optimizing resident education.

Purpose of the Study:

  • To compare the cognitive workload of general surgery residents during simulated robotic-assisted surgery (RAS) versus laparoscopic surgery.
  • To measure prefrontal cortex hemodynamic activity as an indicator of cognitive workload in both simulated environments.
  • To evaluate performance metrics and neurophysiological data to assess training efficiency.

Main Methods:

  • Twenty-two general surgery residents with no prior RAS experience performed a peg transfer task on both laparoscopic and RAS simulators.
  • Prefrontal cortex hemodynamic activity (using ΔHbO) was measured to assess cognitive workload.
  • Performance time, Relative Neural Efficiency (RNE), and Relative Neural Involvement (RNI) were analyzed.

Main Results:

  • Peg transfer times were significantly shorter in RAS simulations compared to laparoscopic simulations.
  • Mean oxygenated hemoglobin (ΔHbO) levels were lower in RAS simulations, indicating reduced cognitive workload.
  • Relative Neural Efficiency (RNE) and Relative Neural Involvement (RNI) scores were higher in RAS tasks, suggesting greater efficiency.

Conclusions:

  • Robotic-assisted surgery (RAS) simulation is associated with lower cognitive workload and enhanced efficiency compared to laparoscopic simulation for general surgery residents.
  • Integrating neurophysiological measures with performance data can provide a more comprehensive assessment of surgical training.
  • These findings support the use of RAS simulators for efficient surgical skills acquisition and training evaluation.