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Surgical Endoscopy
Published in: Surgical Endoscopy 11/2020

01-11-2020

Brain activation during laparoscopic tasks in high- and low-performing medical students: a pilot fMRI study

Authors: Alaina Garbens, Bonnie A. Armstrong, Marisa Louridas, Fred Tam, Allan S. Detsky, Tom A. Schweizer, Simon J. Graham, Teodor Grantcharov

Published in: Surgical Endoscopy | Issue 11/2020

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Abstract

Background

Up to 20% of medical students are unable to reach competency in laparoscopic surgery. It is unknown whether these difficulties arise from heterogeneity in neurological functioning across individuals. We sought to examine the differences in neurological functioning during laparoscopic tasks between high- and low-performing medical students using functional magnetic resonance imaging (fMRI).

Methods

This prospective cohort study enrolled North American medical students who were within the top 20% and bottom 20% of laparoscopic performers from a previous study. Brain activation was recorded using fMRI while participants performed peg-pointing, intracorporeal knot tying (IKT), and the Pictorial Surface Orientation (PicSOr) test. Brain activation maps were created and areas of activation were compared between groups.

Results

In total, 9/12 high and 9/13 low performers completed the study. High performers completed IKT faster and made more successful knot ties than low performers [standing: 23.5 (5.0) sec vs. 37.6 (18.4) sec, p = 0.03; supine: 23.2 (2.5) sec vs. 72.7 (62.8) sec, p = 0.02; number of successful ties supine, 3 ties vs. 1 tie, p = 0.01]. Low performers showed more brain activation than high performers in the peg-pointing task (q < 0.01), with no activation differences in the IKT task. There were no behavioral differences in the PiCSOr task.

Conclusions

This study is the first to show differences between low and high performers of laparoscopic tasks at the brain level. This pilot study has shown the feasibility of using fMRI to examine laparoscopic surgical skills. Future studies are needed for further exploration of our initial findings.
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Metadata
Title
Brain activation during laparoscopic tasks in high- and low-performing medical students: a pilot fMRI study
Authors
Alaina Garbens
Bonnie A. Armstrong
Marisa Louridas
Fred Tam
Allan S. Detsky
Tom A. Schweizer
Simon J. Graham
Teodor Grantcharov
Publication date
01-11-2020
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 11/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-019-07260-5

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