Brain imaging can help determine the surgeon's skills

The use of optical neuroimaging can objectively and successfully classify the levels of expertise associated with bimanual motor dexterity among surgeons and medical students compared to conventional measures, according to a recently published study .

The researchers ranked 17 novice surgeons or experts and 13 medical students qualified or unskilled trainees. Each participant performed a laparoscopic surgery pattern cutting (FLS) task with the aid of a FLS certified simulator. The researchers compared the groups with a control group consisting of medical students without any training. The researchers recorded scores of total time, intensity of light and performance of the pattern cutting task based on FLS measurements, as well as cortical activation in real time, including measurements. of the prefrontal cortex, the primary motor cortex and the additional driving surface, using near infrared functional spectroscopy.

The results showed that expert surgeons significantly surpassed novice surgeons in terms of FLS performance score. Although the researchers found no significant difference in the performance score of French-language services between the untrained control group and the group formed on the first day or during the pretest, participants in the group formed significantly outperformed the group. untrained witness in the final post-test.

The researchers then quantified the hemodynamic activation in real time on the prefrontal cortex, the primary motor cortex and the cortical regions of the additional motor area to confirm that the neuroimaging methodology could discriminate established skill levels. Compared to expert surgeons, the researchers found significantly higher functional activation in prefrontal cortex regions and significantly lower functional activation in the left medial primary motor cortex and additional motor region regions in novice surgeons. According to the results, at the end of the training and after a two-week break, qualified trainees exhibited increased cortical activation in the left medial primary motor cortex and additional motor region, as well as a decrease in activation of the prefrontal cortex compared to unskilled trainees.

When all trainees were compared to the control group, the researchers found no significant difference at the beginning of the training program. However, at the end of training and after a two-week rest period, known and unqualified functional activations showed significantly lower functional activation in the left and right lateral prefrontal cortex, both in trainees and trainees. unskilled. In the post-test, the results showed a significant increase in the left medial primary motor cortex and additional activation of the motor region in FSL-trained students compared to untrained control students. – by Casey Tingle

Disclosures: The authors do not report any relevant financial information.