Maddox Michael M, Lopez Asis, Mandava Sree Harsha, Boonjindasup Aaron, Viriyasiripong Sarayuth, Silberstein Jonathan L, Lee Benjamin R
1 Department of Urology, Tulane University School of Medicine , New Orleans, Louisiana.
2 Department of Biomedical Engineering, Tulane University School of Science and Engineering , New Orleans, Louisiana.
J Endourol. 2015 Dec;29(12):1329-33. doi: 10.1089/end.2015.0239. Epub 2015 Oct 20.
To measure gamma and alpha brain wave activity as a measurement of concentration and stress levels during surgical simulator performance of laparoscopic tasks to determine if expert surgeons have different brain activity patterns compared with intermediate and novice surgeons.
After obtaining Institutional Review Board approval, 1st and 2nd year medical students, urology residents (PGY2-PGY5), and attending urologists from one institution were recruited. Participants were stratified by level of experience and performed laparoscopic tasks on the EDGE laparoscopic simulator. Subjects were evaluated for concentration and stress levels using the electroencephalography (EEG) data extracted from the MUSE(™) headband. The MUSE software developer kit (SDK) allowed quantification of gamma and alpha waves during each task. An analysis of variance was used to compare concentration and stress levels between groups.
A total of 19 participants were recruited for the study and stratified by surgical experience into novice, intermediate, and expert laparoscopy groups: 6 medical students, 9 urology residents, and 4 attending urologists, respectively. Concentration and stress were quantified by calculating the area under the curve of the gamma and alpha EEG wave tracings. Stress was significantly lower in the attending urologists compared with the residents and medical students during the laparoscopic suturing and trended toward significance in the peg transfer task (P = 0.0003, P = 0.069). Concentration was significantly higher in the expert group compared with the less experienced groups during both the peg and suture tasks (P = 0.036, P = 0.0039).
EEG brain activity in more experienced surgeons reveals a significant increase in concentration levels with a decrease in stress during simulated laparoscopic tasks compared with novices. This information may correlate with increased proficiency as well as provide objective feedback of progress along the learning curve with the MUSE SDK.
测量γ和α脑电波活动，以此作为腹腔镜任务手术模拟器操作过程中注意力和压力水平的一种测量方法，以确定专家外科医生与中级和新手外科医生相比是否具有不同的脑活动模式。
获得机构审查委员会批准后，招募了某一机构的一年级和二年级医学生、泌尿外科住院医师（PGY2 - PGY5）以及主治泌尿外科医生。参与者按经验水平分层，并在EDGE腹腔镜模拟器上执行腹腔镜任务。使用从MUSE（™）头带提取的脑电图（EEG）数据评估受试者的注意力和压力水平。MUSE软件开发工具包（SDK）允许在每个任务期间对γ和α波进行量化。采用方差分析比较各组之间的注意力和压力水平。
本研究共招募了19名参与者，并按手术经验分为新手、中级和专家腹腔镜组：分别为6名医学生、9名泌尿外科住院医师和4名主治泌尿外科医生。通过计算γ和α脑电波形曲线下的面积来量化注意力和压力。在腹腔镜缝合过程中，主治泌尿外科医生的压力明显低于住院医师和医学生，在移钉任务中压力有显著差异的趋势（P = 0.0003，P = 0.069）。在移钉和缝合任务中，专家组的注意力明显高于经验较少的组（P = 0.036，P = 0.0039）。
与新手相比，经验更丰富的外科医生在模拟腹腔镜任务中的脑电图活动显示，注意力水平显著提高，压力降低。这些信息可能与熟练度的提高相关，同时通过MUSE SDK为学习曲线中的进展提供客观反馈。
