Cognitive assessment provides window into proficiency level of robot-assisted surgeons

July 9, 2014, Roswell Park Cancer Institute

(Medical Xpress)—What clues might brain metrics hold about the skill levels of surgeons who perform robot-assisted surgeries? Looking for better ways to assess the proficiency of surgeons performing these complex procedures, researchers at Roswell Park Cancer Institute (RPCI) and the University at Buffalo (UB) determined whether cognitive assessment can effectively measure the expertise of robotic surgeons with varying levels of experience. They found that assessment of robotic surgeons' cognitive processes during surgery gives a fuller, more reliable picture than other measurable indicators, and may be a valuable element to incorporate into robotic surgery training.

The study, published online ahead of print in the journal BJUI, is the first published report to evaluate surgeons' cognition during robot-assisted surgery.

The research team evaluated novice, competent and expert robotic surgeons using both tool-based measures available through the daVinci Surgical System and continuous wireless electroencephalography (EEG) recording. Most of the 10 surgeons enrolled—two residents, three fellows and five practicing surgeons—were assessed on basic, intermediate and advanced surgical tasks. Those assigned to the novice group were assessed only on basic and intermediate skills. Each participant completed a pre-recording session to establish baseline responses.

For the cognitive testing, the participants' cognitive engagement, mental workload and were calculated from the measured EEG during each task. When they compared the results of both testing approaches among the three groups, the researchers found that cognitive assessment detected significant differences that were not identified by the tool-based metrics available through the surgical robot.

"The real distinctions emerged when we looked at the cognitive differences between our intermediate and expert groups," notes the study's first author, Khurshid Guru, MD, Director of Robotic Surgery and the Robert P. Huben Endowed Professor of Oncology at RPCI.

"We saw that the middle group, those considered competent but not expert, demonstrated greater high-level engagement, higher mental state and more cognitive load to complete each task when performing intermediate and advanced tasks—in other words, they had to work harder and devote more mental resources than the expert group," added co-author Ehsan T. Esfahani, PhD, an Assistant Professor in UB's Department of Mechanical and Aerospace Engineering and Director of the UB Brain Computer Interface Laboratory.

The researchers concluded that cognitive assessment is an effective complement to traditional methods of assessing the skill level of robotic surgeons at various stages of development and can be used to help tailor training programs to their individual needs. The authors acknowledge that further testing will be needed to validate the findings of this small study.

"Our results truly provided a window into how novice robotic surgeons develop into expert robotic , how they evolve to a point where they're using their intuition, pre-planning their actions and demonstrating high comfort and competence in interacting with the machine," adds Dr. Guru, who is also Director of the Institute's ATLAS Project, or Applied Technology Laboratory for Advanced Surgery. "The implications for patient safety are striking. I think in the future we're going to see cognitive assessment widely incorporated into surgeon training programs, and the model our team developed is a good foundation for subsequent investigations."

The testing was performed at RPCI in collaboration with UB's Brain Computer Interface Laboratory. Assessments were conducted using training modules and surgeries performed on synthetic organ models; no live surgeries were involved.

Explore further: Study results indicate Fundamental Skills of Robotic Surgery appears to be effective way to train surgeons

More information: Khurshid A. Guru, et al. "Cognitive Skills Assessment during Robot-Assisted Surgery: Separating Wheat from Chaff." DOI: 10.1111/bju.12657

Related Stories

Study results indicate Fundamental Skills of Robotic Surgery appears to be effective way to train surgeons

March 13, 2013
Researchers from Roswell Park Cancer Institute (RPCI) and four collaborating institutions have evaluated the effectiveness of a novel curriculum to safely train surgeons on the da Vinci Surgical System, which is used to perform ...

Specific modules for robot-assisted surgery debuts

May 13, 2011
Two life-sciences entrepreneurs are launching the first procedure-specific software modules for robot-assisted surgery.

Rapid surgical innovation puts patients at risk for medical errors

July 2, 2014
Researchers at the University of California, San Diego School of Medicine have found that the risk of patient harm increased two-fold in 2006 – the peak year that teaching hospitals nationwide embraced the pursuit of minimally ...

Anonymous peer feedback through social networking helped residents improve their skills

June 17, 2014
Surgical residents who received anonymous feedback from their peers through a social networking site on their robotic surgery skills improved more than those who did not receive any peer feedback on their procedures, UCLA ...

Recommended for you

Drug may help surgical patients stop opioids sooner

December 13, 2017
(HealthDay)—Opioid painkillers after surgery can be the first step toward addiction for some patients. But a common drug might cut the amount of narcotics that patients need, a new study finds.

Children best placed to explain facts of surgery to patients, say experts

December 13, 2017
Getting children to design patient information leaflets may improve patient understanding before they have surgery, finds an article in the Christmas issue of The BMJ.

Burn victim saved by skin grafts from identical twin (Update)

November 23, 2017
A man doomed to die after suffering burns across 95 percent of his body was saved by skin transplants from his identical twin in a world-first operation, French doctors said Thursday.

Is a common shoulder surgery useless?

November 21, 2017
(HealthDay)—New research casts doubt on the true effectiveness of a common type of surgery used to ease shoulder pain.

Study shows electric bandages can fight biofilm infection, antimicrobial resistance

November 6, 2017
Researchers at The Ohio State University Wexner Medical Center have shown - for the first time - that special bandages using weak electric fields to disrupt bacterial biofilm infection can prevent infections, combat antibiotic ...

Obesity increases incidence, severity, costs of knee dislocations

November 3, 2017
A new study of more than 19,000 knee dislocation cases in the U.S. between 2000 and 2012 provides a painful indication of how the nation's obesity epidemic is changing the risk, severity and cost of a traumatic injury.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.