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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
Summary
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.
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.
