Electric neurostimulation can improve surgical skills

The skills required to perform laparoscopic keyhole surgery can be significantly enhanced by applying electric neurostimulation during training, new Irish research has found.

Enhancing surgical skills is key to reducing surgery times and improving clinical outcomes.

Researchers at Lero’s Esports Science Research Lab (ESRL) at the University of Limerick (UL) and the ASSERT centre at University College Cork (UCC), have found that medical students performed some surgical tasks significantly better when they wore a custom headset delivering transcranial direct current stimulation (tDCS) compared to those who wore a headset but did not receive tDCS neurostimulation while performing the training tasks.

“Establishing optimal methods to assess and enhance surgical skill benefits surgeons, who may complete tasks more efficiently and rapidly with reduced incidence of patient follow-up. It also benefits patients who experience improved clinical outcomes, as well as the healthcare system seen through a reduction in healthcare costs,” explained Lero and University of Limerick researcher, Prof Mark Campbell.

Fifty-three participants – 27 females and 26 males – took part in testing and training sessions at the ASSERT surgical simulation lab at UCC. These sessions revealed that males and females reacted similarly, however not all surgical skills were improved by neurostimulation.

A laparoscopic skill analyser was used to assess performance on surgical tasks at baseline, post-training and retention sessions. The novice surgical participants were evaluated on their ability to complete two predefined training modules. These were a bead transfer task and a threading task, with participants randomly assigned to either an active or sham tDCS stimulation group for the duration of the study. 

“Five days after the completion of training, all students improved their skill levels, but those in the stimulation group performed significantly better on the bead test while we failed to detect a significant difference in the level of improvement on the threading task. Overall, those in the stimulation group performed their tasks up to 30 seconds faster,” explained Lero and University of Limerick researcher, Dr Adam Toth.

Meanwhile, according to Dr Daniel Galvin from the ASSERT centre, the study also found that those in the stimulation group “moved their surgical implements less and more smoothly than those in the sham group's retention test”.

“This could lead to better outcomes for patients in real-life situations,” he noted.

The researchers said that this work significantly contributes to a growing body of research investigating the effects of neurostimulation on sensory-motor performance and demonstrates laparoscopic simulation training as a fruitful avenue to study motor learning and the impact of neurostimulation on motor skill development.

The team had carried out extensive research into electric neurostimulation in the field of esports and following on from this, they wanted to investigate the application of these findings in other domains, notably surgery.

The participants were recruited from the UCC medical student population and all were naïve to laparoscopic skills training. 

Lero is the Science Foundation Ireland Research Centre for Software. It brings together expert software teams from universities and institutes of technology across Ireland in a co-ordinated centre of research excellence with a strong industry focus. For more information, click here.