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The frontal cortex is activated during learning of endoscopic procedures

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Abstract

Background

To date, several training and evaluation systems for endoscopic surgery have been developed, such as virtual-reality simulators and box trainers. However, despite current advances in these objective assessments, no functional brain studies during learning of endoscopic surgical skills have been carried out. In the present study, we investigated cortical activation using near-infrared spectroscopy (NIRS) during endoscopic surgical tasks.

Study design

A total of 21 right-handed subjects, comprising 4 surgical experts, 4 trainees, and 13 novices, participated in the study. Suturing and knot-tying tasks were performed in a box trainer. Cortical activation was assessed in all subjects by task-related changes in hemoglobin (Hb) oxygenation using NIRS.

Results

In surgical experts and novices with no experience of endoscopic surgical training, we found no changes in oxy-Hb, deoxy-Hb or total-Hb levels in any of the frontal channels. In surgical trainees and one novice with experience of endoscopic surgical training, we found significant increases in oxy-Hb and total-Hb levels in most of the frontal channels. There were significant differences in oxy-Hb and total-Hb levels in CH-19 between surgical experts and trainees (p = 0.02 for both), and between surgical trainees and novices with no experience of endoscopic surgical training (p = 0.008 for both). Furthermore, additional training increased oxy-Hb levels in the frontal cortex of novices with no experience of endoscopic surgical training but had no such effect on surgical experts.

Conclusions

The present data suggest that NIRS is a feasible tool for assessing brain activation during endoscopic surgical tasks, and may have a large impact on the future development of teaching, training, and assessment methods for endoscopic surgical skills.

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Abbreviations

NIRS:

Near-infrared spectroscopy

Hb:

Hemoglobin

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Authors and Affiliations

  1. Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka, 812-8582, Japan

    Kenoki Ohuchida, Hajime Kenmotsu & Makoto Hashizume

  2. Department of Surgery and Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan

    Kenoki Ohuchida & Masao Tanaka

  3. Applied Systems Development Group, New Product Technologies Development Department, Matsushita Electric Works Ltd., Osaka, Japan

    Atsuyuki Yamamoto & Kazuya Sawada

  4. Department of Digital Medicine Initiative, Kyushu University, Fukuoka, Japan

    Takehito Hayami & Kenichi Morooka

  5. Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan

    Shinichiro Takasugi & Yukihide Iwamoto

  6. Department of Future Medicine and Innovative Medical Information, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan

    Kozo Konishi & Makoto Hashizume

  7. Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Fukuoka, Japan

    Satoshi Ieiri, Kazuo Tanoue & Makoto Hashizume

Authors
  1. Kenoki Ohuchida
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  2. Hajime Kenmotsu
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  3. Atsuyuki Yamamoto
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  4. Kazuya Sawada
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  5. Takehito Hayami
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  7. Shinichiro Takasugi
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  8. Kozo Konishi
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  9. Satoshi Ieiri
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  10. Kazuo Tanoue
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  11. Yukihide Iwamoto
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  12. Masao Tanaka
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  13. Makoto Hashizume
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Corresponding author

Correspondence to Makoto Hashizume.

Additional information

Supported in part by a grant from the New Energy and Industrial Technology Development Organization.

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Ohuchida, K., Kenmotsu, H., Yamamoto, A. et al. The frontal cortex is activated during learning of endoscopic procedures. Surg Endosc 23, 2296–2301 (2009). https://doi.org/10.1007/s00464-008-0316-z

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  • DOI: https://doi.org/10.1007/s00464-008-0316-z

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