Imperial College London
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Mr Daniel Richard Leff

Faculty of Medicine, Department of Surgery & Cancer

Reader in Breast Surgery
 
 
 
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Contact

 

d.leff Website

 
 
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Location

 

016Paterson WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Patel:2022:10.1007/s00464-021-08823-1,
author = {Patel, R and Suwa, Y and Kinross, J and von, Roon A and Woods, AJ and Darzi, A and Singh, H and Leff, DR},
doi = {10.1007/s00464-021-08823-1},
journal = {Surgical Endoscopy: surgical and interventional techniques},
pages = {4803--4814},
title = {Neuroenhancement of surgeons during robotic suturing},
url = {http://dx.doi.org/10.1007/s00464-021-08823-1},
volume = {36},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundThe initial phases of robotic surgical skills acquisition are associated with poor technical performance, such as low knot-tensile strength (KTS). Transcranial direct-current stimulation (tDCS) can improve force and accuracy in motor tasks but research in surgery is limited to open and laparoscopic tasks in students. More recently, robotic surgery has gained traction and is now the most common approach for certain procedures (e.g. prostatectomy). Early-phase robotic suturing performance is dependent on prefrontal cortex (PFC) activation, and this study aimed to determine whether performance can be improved with prefrontal tDCS.MethodsFifteen surgical residents were randomized to either active then sham tDCS or sham then active tDCS, in two counterbalanced sessions in a double-blind crossover study. Within each session, participants performed a robotic suturing task repeated in three blocks: pre-, intra- and post-tDCS. During the intra-tDCS block, participants were randomized to either active tDCS (2 mA for 15 min) to the PFC or sham tDCS. Primary outcome measures of technical quality included KTS and error scores.ResultsSignificantly faster completion times were observed longitudinally, regardless of active (p < 0.001) or sham stimulation (p < 0.001). KTS was greater following active compared to sham stimulation (median: active = 44.35 N vs. sham = 27.12 N, p < 0.001). A significant reduction in error scores from “pre-” to “post-” (p = 0.029) were only observed in the active group.ConclusiontDCS could reduce error and enhance KTS during robotic suturing and warrants further exploration as an adjunct to robotic surgical training.
AU  - Patel,R
AU  - Suwa,Y
AU  - Kinross,J
AU  - von,Roon A
AU  - Woods,AJ
AU  - Darzi,A
AU  - Singh,H
AU  - Leff,DR
DO  - 10.1007/s00464-021-08823-1
EP  - 4814
PY  - 2022///
SN  - 0930-2794
SP  - 4803
TI  - Neuroenhancement of surgeons during robotic suturing
T2  - Surgical Endoscopy: surgical and interventional techniques
UR  - http://dx.doi.org/10.1007/s00464-021-08823-1
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000713580500013&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://link.springer.com/article/10.1007%2Fs00464-021-08823-1
UR  - http://hdl.handle.net/10044/1/92450
VL  - 36
ER  -
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