The frontal cortex is activated during learning of endoscopic procedures

Kenoki Ohuchida, Hajime Kenmotsu, Atsuyuki Yamamoto, Kazuya Sawada, Takehito Hayami, Kenichi Morooka, Shinichiro Takasugi, Kozo Konishi, Satoshi Ieiri, Kazuo Tanoue, Yukihide Iwamoto, Masao Tanaka, Makoto Hashizume

Research output: Contribution to journalArticle

26 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)2296-2301
Number of pages6
JournalSurgical Endoscopy
Volume23
Issue number10
DOIs
Publication statusPublished - Oct 2009
Externally publishedYes

Keywords

  • Cortical activation
  • Endoscopic surgery
  • Near-infrared spectroscopy (NIRS)
  • Suturing and knot tying

ASJC Scopus subject areas

  • Surgery

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  • Cite this

    Ohuchida, K., Kenmotsu, H., Yamamoto, A., Sawada, K., Hayami, T., Morooka, K., Takasugi, S., Konishi, K., Ieiri, S., Tanoue, K., Iwamoto, Y., Tanaka, M., & Hashizume, M. (2009). The frontal cortex is activated during learning of endoscopic procedures. Surgical Endoscopy, 23(10), 2296-2301. https://doi.org/10.1007/s00464-008-0316-z