Training Skills in Minimally Invasive, Robotic and Open Surgery: Brain Activation as an Opportunity for Learning
| Autor: | Carlo Cavaliere, Lucilla Cardinali, Marco Aiello, Placido Bramanti, Andrea Soddu, Gloria Pelizzo, Emanuela Mazzon, Valeria Calcaterra, Lilla Bonanno, Silvia Marino |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Brain activation medicine.medical_specialty Adolescent Surgical training education Open surgery Young Adult Robotic Surgical Procedures Minimally invasive surgery Humans Medicine Robotic surgery Functional MRI Surgeons medicine.diagnostic_test business.industry Brain Magnetic Resonance Imaging Training skills Functional imaging Learning curve General Surgery Physical therapy Female Laparoscopy Surgery business Functional magnetic resonance imaging Learning Curve |
| Zdroj: | Brain and Mind Institute Researchers' Publications |
| Popis: | Introduction: The advantages of the robotic approach in surgery are undisputed. However, during surgical training, how this technique influences the learning curve has not been described. We provide a tentative model for analyzing the learning curves associated with observation and active participation in learning different surgical techniques, using functional imaging. Methods: Forty medical students were enrolled and assigned to 4 groups who underwent training in robotic (ROB), laparoscopic (LAP), or open (OPEN) surgery, and a control group that performed motor training without surgical instruments. Surgical/motor training included six 1-h sessions completed over 6 days of the same week. All subjects underwent functional magnetic resonance imaging (fMRI) scanning sessions, before and after surgical training during. Results: Twenty-three participants completed the study. The 3 surgical groups exhibited different learning curves during training. The main effects of the day of training (p < 0.01) and the group (p < 0.01) as well as a significant interaction of day of training group (p < 0.01) were observed. The performance increased in the first 4 days, reaching a peak at day 4, when all groups were considered together. The OPEN group showed the best performance compared to all other groups (p < 0.04). The OPEN group showed a rapid improvement in performance, which peaked at day 4 and decreased on the last day. Similarly, the LAP group showed a steady increase in the number of exercises they completed, which continued for the entire training period and reached a peak on the last day. However, the participants training in ROB surgery, after a performance initially indistinguishable from that of the LAP group, had a dip in their performance, quickly followed by an improvement and reaching a plateau on day 4. fMRI analysis documented the different involvement of the cortical and subcortical areas based on the type of training. Surgical training modified the activation of some brain regions during both observation and the execution of tasks. Conclusions: Differences in the learning curves of the 3 surgical groups were noted. Functional brain activity represents an interesting starting point to guide training programs. |
| Databáze: | OpenAIRE |
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