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Neuroanatomical correlates of laparoscopic surgery training

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Abstract

Background

Better understanding of the brain regions involved in performing laparoscopic surgery is likely to provide important insights for improving laparoscopic training and assessment in the future. To our knowledge, this is the first study using real Fundamentals of Laparoscopy Training (FLS)-based laparoscopic surgery training tasks in the functional magnetic resonance imaging (fMRI) environment to provide extensive characterization of the brain regions involved in this specific task execution.

Methods

Nine right-handed subjects practiced five FLS-modified laparoscopic surgery-training tasks with a training box for ten sessions in a simulated fMRI environment. Following the last practice session, they underwent 3 T fMRI while performing each task.

Results

An increase in the extent of brain activation was observed as the complexity of the tasks increased. Activation in the precentral gyrus, postcentral gyrus, and premotor regions was observed in the performance of all tasks, whereas the superior parietal lobe (SPL) was activated in the more complex tasks. The mean score and brain activation for performance with the dominant hand were larger than those observed during performance with the non-dominant hand.

Conclusions

Performing more complex tasks requires higher visual spatial ability and motor planning. Given the need for ambidextrous skills during laparoscopic tasks, the finding that lower scores and smaller brain recruitment occurred in executing tasks with the non-dominant hand than with the dominant hand suggests designing future training tasks to train the non-dominant hand more effectively. This may serve to improve overall performance in bi-manual tasks. Studies of this kind may facilitate the evidence-based development of strategies to improve the quality of laparoscopy training and assessment.

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Acknowledgments

The authors acknowledge the generous Grant support from the Natural Sciences and Engineering Research Council (NSERC) of Canada.

Disclosure

P. Bahrami, Dr. S.J. Graham, Dr. T.P. Grantcharov, Dr. M.D. Cusimano, Dr. O.D. Rotstein, A. Mansur, and Dr. T.A. Schweizer have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada

    Parisa Bahrami & Tom A. Schweizer

  2. Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Simon J. Graham

  3. Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada

    Simon J. Graham

  4. Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada

    Teodor P. Grantcharov, Michael D. Cusimano, Ori D. Rotstein, Ann Mansur & Tom A. Schweizer

  5. Department of Surgery, St. Michael’s Hospital, Toronto, ON, Canada

    Teodor P. Grantcharov, Michael D. Cusimano, Ori D. Rotstein & Tom A. Schweizer

  6. Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada

    Michael D. Cusimano, Ori D. Rotstein & Tom A. Schweizer

Authors
  1. Parisa Bahrami
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  2. Simon J. Graham
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  3. Teodor P. Grantcharov
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  4. Michael D. Cusimano
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  5. Ori D. Rotstein
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  6. Ann Mansur
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  7. Tom A. Schweizer
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Corresponding author

Correspondence to Tom A. Schweizer.

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Bahrami, P., Graham, S.J., Grantcharov, T.P. et al. Neuroanatomical correlates of laparoscopic surgery training. Surg Endosc 28, 2189–2198 (2014). https://doi.org/10.1007/s00464-014-3452-7

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  • DOI: https://doi.org/10.1007/s00464-014-3452-7

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