Neuroenhancement of surgeons during robotic suturing

Patel, Ronak; Suwa, Yusuke; Roon, Alexander von; Woods, Adam J.; Darzi, Ara; Singh, Harsimrat; Leff, Daniel

doi:10.1007/s00464-021-08823-1

“…This interpretation aligns with previous studies showing that tDCS improved shooting precision in ballistic sports like tennis or basketball 29 – 31 . Overall, our findings on skill learning also fit with recent research showing promising effects of tDCS compared to sham stimulation (mostly applied to M1 or the pre-frontal cortex) in the context of open 32 , laparoscopic 33 – 37 , robot-assisted 38 , and virtual reality 39 surgical training.…”

Section: Discussionsupporting

confidence: 89%

Anodal cerebellar t-DCS impacts skill learning and transfer on a robotic surgery training task

Caccianiga,

Mooney,

Celnik

et al. 2023

Sci Rep

0

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The cerebellum has demonstrated a critical role during adaptation in motor learning. However, the extent to which it can contribute to the skill acquisition of complex real-world tasks remains unclear. One particularly challenging application in terms of motor activities is robotic surgery, which requires surgeons to complete complex multidimensional visuomotor tasks through a remotely operated robot. Given the need for high skill proficiency and the lack of haptic feedback, there is a pressing need for understanding and improving skill development. We investigated the effect of cerebellar transcranial direct current stimulation applied during the execution of a robotic surgery training task. Study participants received either real or sham stimulation while performing a needle driving task in a virtual (simulated) and a real-world (actual surgical robot) setting. We found that cerebellar stimulation significantly improved performance compared to sham stimulation at fast (more demanding) execution speeds in both virtual and real-world training settings. Furthermore, participants that received cerebellar stimulation more effectively transferred the skills they acquired during virtual training to the real world. Our findings underline the potential of non-invasive brain stimulation to enhance skill learning and transfer in real-world relevant tasks and, more broadly, its potential for improving complex motor learning.

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“…This interpretation aligns with previous studies showing that tDCS improved shooting precision in ballistic sports like tennis or basketball [25][26][27] . Overall, our findings on skill learning also fit with recent research showing promising effects of tDCS compared to sham (mostly applied to M1 or the pre-frontal cortex) in the context of open 28 , laparoscopic [29][30][31][32][33] , robot-assisted 34 , and virtual reality 35 surgical training.…”

Section: Cb-atdcs Shamsupporting

confidence: 89%

Anodal Cerebellar t-DCS Impacts Skill Learning and Transfer on a Robotic Surgery Training Task

Caccianiga

¹

,

Mooney²,

Celnik³

et al. 2023

Preprint

0

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The cerebellum has demonstrated a critical role during adaptation in motor learning. However, the extent to which it can contribute to the skill acquisition of complex real-world tasks remains unclear. One particularly challenging application in terms of motor activities is robotic surgery, which requires surgeons to complete complex multidimensional visuomotor tasks through a remotely operated robot. Given the need for high skill proficiency and the lack of haptic feedback, there is a pressing need for understanding and improving skill development. We investigated the effect of cerebellar transcranial direct current stimulation applied during the execution of a robotic surgery training task. Study participants received either real or sham stimulation while performing a needle driving task in a virtual (simulated) and a real-world (actual surgical robot) setting. We found that cerebellar stimulation significantly improved performance compared to sham stimulation at fast (more demanding) execution speeds in both virtual and real-world training settings. Furthermore, participants that received cerebellar stimulation more effectively transferred the skills they acquired during virtual training to the real world. Our findings underline the potential of non-invasive brain stimulation to enhance skill learning and transfer in real-world relevant tasks and, more broadly, its potential for improving complex motor learning.

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“… 44 More invasive neurostimulation techniques were also tested; transcranial direct current stimulation on surgeons completing a knot typing task in robotic surgery was reported to have increased knot tensile strength. 45 Cognitive surgical technologies (CSTs) incorporating augmented reality (AR) and image guidance have shown promising results in improving precision and reducing errors in various surgical procedures. Similar to other visual aid CSTs, AR-based CSTs also rely on radiology images to create a patient-specific 3-D model.…”

Section: Discussionmentioning

confidence: 99%

A Review of Cognitive Support Systems in the Operating Room

Zhang,

Wu,

Zheng

2023

Surg Innov

2

0

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Background In recent years, numerous innovative yet challenging surgeries, such as minimally invasive procedures, have introduced an overwhelming amount of new technologies, increasing the cognitive load for surgeons and potentially diluting their attention. Cognitive support technologies (CSTs) have been in development to reduce surgeons’ cognitive load and minimize errors. Despite its huge demands, it still lacks a systematic review. Methods Literature was searched up until May 21st, 2021. Pubmed, Web of Science, and IEEExplore. Studies that aimed at reducing the cognitive load of surgeons were included. Additionally, studies that contained an experimental trial with real patients and real surgeons were prioritized, although phantom and animal studies were also included. Major outcomes that were assessed included surgical error, anatomical localization accuracy, total procedural time, and patient outcome. Results A total of 37 studies were included. Overall, the implementation of CSTs had better surgical performance than the traditional methods. Most studies reported decreased error rate and increased efficiency. In terms of accuracy, most CSTs had over 90% accuracy in identifying anatomical markers with an error margin below 5 mm. Most studies reported a decrease in surgical time, although some were statistically insignificant. Discussion CSTs have been shown to reduce the mental workload of surgeons. However, the limited ergonomic design of current CSTs has hindered their widespread use in the clinical setting. Overall, more clinical data on actual patients is needed to provide concrete evidence before the ubiquitous implementation of CSTs.

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Neuroenhancement of surgeons during robotic suturing

Cited by 8 publications

References 73 publications

Anodal cerebellar t-DCS impacts skill learning and transfer on a robotic surgery training task

Anodal cerebellar t-DCS impacts skill learning and transfer on a robotic surgery training task

Anodal Cerebellar t-DCS Impacts Skill Learning and Transfer on a Robotic Surgery Training Task

A Review of Cognitive Support Systems in the Operating Room

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