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Robotic Surgery Improves Technical Performance and Enhances Prefrontal Activation During High Temporal Demand

Overview of attention for article published in Annals of Biomedical Engineering, June 2018
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Title
Robotic Surgery Improves Technical Performance and Enhances Prefrontal Activation During High Temporal Demand
Published in
Annals of Biomedical Engineering, June 2018
DOI 10.1007/s10439-018-2049-z
Pubmed ID
Authors

Harsimrat Singh, Hemel N. Modi, Samriddha Ranjan, James W. R. Dilley, Dimitrios Airantzis, Guang-Zhong Yang, Ara Darzi, Daniel R. Leff

Abstract

Robotic surgery may improve technical performance and reduce mental demands compared to laparoscopic surgery. However, no studies have directly compared the impact of robotic and laparoscopic techniques on surgeons' brain function. This study aimed to assess the effect of the operative platform (robotic surgery or conventional laparoscopy) on prefrontal cortical activation during a suturing task performed under temporal demand. Eight surgeons (mean age ± SD = 34.5 ± 2.9 years, male:female ratio = 7:1) performed an intracorporeal suturing task in a self-paced manner and under a 2 min time restriction using conventional laparoscopic and robotic techniques. Prefrontal activation was assessed using near-infrared spectroscopy, subjective workload was captured using SURG-TLX questionnaires, and a continuous heart rate monitor measured systemic stress responses. Task progression scores (au), error scores (au), leak volumes (mL) and knot tensile strengths (N) provided objective assessment of technical performance. Under time pressure, robotic suturing led to improved technical performance (median task progression score: laparoscopic suturing = 4.5 vs. robotic suturing = 5.0; z = - 2.107, p = 0.035; median error score: laparoscopic suturing = 3.0 mm vs. robotic suturing = 2.1 mm; z = - 2.488, p = 0.013). Compared to laparoscopic suturing, greater prefrontal activation was identified in seven channels located primarily in lateral prefrontal regions. These results suggest that robotic surgery improves performance during high workload conditions and is associated with enhanced activation in regions of attention, concentration and task engagement.

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Geographical breakdown

Country Count As %
Unknown 63 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 10 16%
Student > Master 9 14%
Student > Bachelor 9 14%
Student > Postgraduate 6 10%
Researcher 6 10%
Other 8 13%
Unknown 15 24%
Readers by discipline Count As %
Medicine and Dentistry 16 25%
Engineering 8 13%
Neuroscience 3 5%
Social Sciences 3 5%
Unspecified 3 5%
Other 10 16%
Unknown 20 32%