The Impact of Minimally Invasive Surgical Modality and Task Complexity on Cognitive Workload: An fNIRS Study
Background: Minimally invasive surgical techniques, including laparoscopic and robotic surgery, have profoundly impacted surgical practice by improving precision, reducing recovery times, and minimizing complications. However, these modalities differ in their cognitive demands and skill acquisition...
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MDPI AG
2025-04-01
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| author | Fuat Ücrak Kurtulus Izzetoglu Mert Deniz Polat Ümit Gür Turan Şahin Serhat Ilgaz Yöner Neslihan Gökmen İnan Mehmet Emin Aksoy Cengizhan Öztürk |
| author_facet | Fuat Ücrak Kurtulus Izzetoglu Mert Deniz Polat Ümit Gür Turan Şahin Serhat Ilgaz Yöner Neslihan Gökmen İnan Mehmet Emin Aksoy Cengizhan Öztürk |
| author_sort | Fuat Ücrak |
| collection | DOAJ |
| description | Background: Minimally invasive surgical techniques, including laparoscopic and robotic surgery, have profoundly impacted surgical practice by improving precision, reducing recovery times, and minimizing complications. However, these modalities differ in their cognitive demands and skill acquisition requirements, which can influence the learning curve and operative performance. To assess and evaluate this variability across these modalities, a functional near-infrared spectroscopy (fNIRS) system is used as an objective method for monitoring cognitive activity in surgical trainees. fNIRS can provide insights and further our understanding of the mental demands of different surgical techniques and their association with varying task complexity. Objective: This study seeks to assess the influence of surgical modality (laparoscopy vs. robotic surgery) and task complexity (pick and place (PP) vs. knot tying (KT)) on cognitive workload through fNIRS. We compare real-world and simulation-based training environments to determine changes in brain activation patterns and task performance. Methods: A total of twenty-six surgical trainees (general and gynecologic surgery residents and specialists) participated in this study. Participants completed standardized laparoscopic and robotic surgical tasks at varying levels of complexity while their cognitive workload was measured using fNIRS. This study included both simulation-based training and real-world surgical environments. Hemodynamic responses in the prefrontal cortex (PFC), task completion times, and performance metrics were analyzed. Results: Laparoscopic surgery elicited higher activity changes in the prefrontal cortex, indicating increased cognitive demand compared with robotic surgery, particularly for complex tasks like knot tying. Task complexity significantly influenced mental load, with more intricate procedures eliciting greater neural activation. Real-world training resulted in higher cognitive engagement than simulation, emphasizing the gap between simulated and actual surgical performance. Conclusions: Cognitive workload was lower and significantly different during robotic surgery than during laparoscopy, potentially due to its ergonomic advantages and enhanced motor control. Simulation-based training effectively prepares surgeons, but the cognitive workload results indicate that it may not fully replicate real-world surgical environments. These findings reveal the importance of cognitive workload assessment in surgical education and suggest that incorporating neuroimaging techniques such as fNIRS into training programs could enhance skill acquisition and performance. |
| format | Article |
| id | doaj-art-8b04e10b788141d389ea2fe61b23b2fc |
| institution | OA Journals |
| issn | 2076-3425 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | MDPI AG |
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| series | Brain Sciences |
| spelling | doaj-art-8b04e10b788141d389ea2fe61b23b2fc2025-08-20T02:17:20ZengMDPI AGBrain Sciences2076-34252025-04-0115438710.3390/brainsci15040387The Impact of Minimally Invasive Surgical Modality and Task Complexity on Cognitive Workload: An fNIRS StudyFuat Ücrak0Kurtulus Izzetoglu1Mert Deniz Polat2Ümit Gür3Turan Şahin4Serhat Ilgaz Yöner5Neslihan Gökmen İnan6Mehmet Emin Aksoy7Cengizhan Öztürk8The Institute of Biomedical Engineering, Boğaziçi University, Istanbul 34342, TurkeySchool of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, USASchool of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, USAGeneral Surgery, Istanbul Haseki Training and Research Hospital, Istanbul 34250, TurkeyGynecologic Surgery, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul 34785, TurkeyDepartment of Biomedical Device Technology, Acibadem Mehmet Ali Aydinlar University, Istanbul 34752, TurkeyDepartment of Computer Engineering, Koç University College of Engineering, Istanbul 34450, TurkeyDepartment of Biomedical Device Technology, Acibadem Mehmet Ali Aydinlar University, Istanbul 34752, TurkeyThe Institute of Biomedical Engineering, Boğaziçi University, Istanbul 34342, TurkeyBackground: Minimally invasive surgical techniques, including laparoscopic and robotic surgery, have profoundly impacted surgical practice by improving precision, reducing recovery times, and minimizing complications. However, these modalities differ in their cognitive demands and skill acquisition requirements, which can influence the learning curve and operative performance. To assess and evaluate this variability across these modalities, a functional near-infrared spectroscopy (fNIRS) system is used as an objective method for monitoring cognitive activity in surgical trainees. fNIRS can provide insights and further our understanding of the mental demands of different surgical techniques and their association with varying task complexity. Objective: This study seeks to assess the influence of surgical modality (laparoscopy vs. robotic surgery) and task complexity (pick and place (PP) vs. knot tying (KT)) on cognitive workload through fNIRS. We compare real-world and simulation-based training environments to determine changes in brain activation patterns and task performance. Methods: A total of twenty-six surgical trainees (general and gynecologic surgery residents and specialists) participated in this study. Participants completed standardized laparoscopic and robotic surgical tasks at varying levels of complexity while their cognitive workload was measured using fNIRS. This study included both simulation-based training and real-world surgical environments. Hemodynamic responses in the prefrontal cortex (PFC), task completion times, and performance metrics were analyzed. Results: Laparoscopic surgery elicited higher activity changes in the prefrontal cortex, indicating increased cognitive demand compared with robotic surgery, particularly for complex tasks like knot tying. Task complexity significantly influenced mental load, with more intricate procedures eliciting greater neural activation. Real-world training resulted in higher cognitive engagement than simulation, emphasizing the gap between simulated and actual surgical performance. Conclusions: Cognitive workload was lower and significantly different during robotic surgery than during laparoscopy, potentially due to its ergonomic advantages and enhanced motor control. Simulation-based training effectively prepares surgeons, but the cognitive workload results indicate that it may not fully replicate real-world surgical environments. These findings reveal the importance of cognitive workload assessment in surgical education and suggest that incorporating neuroimaging techniques such as fNIRS into training programs could enhance skill acquisition and performance.https://www.mdpi.com/2076-3425/15/4/387minimally invasive surgerylaparoscopic surgeryrobotic surgerycognitive workloadfunctional near-infrared spectroscopy (fNIRS)surgical training |
| spellingShingle | Fuat Ücrak Kurtulus Izzetoglu Mert Deniz Polat Ümit Gür Turan Şahin Serhat Ilgaz Yöner Neslihan Gökmen İnan Mehmet Emin Aksoy Cengizhan Öztürk The Impact of Minimally Invasive Surgical Modality and Task Complexity on Cognitive Workload: An fNIRS Study Brain Sciences minimally invasive surgery laparoscopic surgery robotic surgery cognitive workload functional near-infrared spectroscopy (fNIRS) surgical training |
| title | The Impact of Minimally Invasive Surgical Modality and Task Complexity on Cognitive Workload: An fNIRS Study |
| title_full | The Impact of Minimally Invasive Surgical Modality and Task Complexity on Cognitive Workload: An fNIRS Study |
| title_fullStr | The Impact of Minimally Invasive Surgical Modality and Task Complexity on Cognitive Workload: An fNIRS Study |
| title_full_unstemmed | The Impact of Minimally Invasive Surgical Modality and Task Complexity on Cognitive Workload: An fNIRS Study |
| title_short | The Impact of Minimally Invasive Surgical Modality and Task Complexity on Cognitive Workload: An fNIRS Study |
| title_sort | impact of minimally invasive surgical modality and task complexity on cognitive workload an fnirs study |
| topic | minimally invasive surgery laparoscopic surgery robotic surgery cognitive workload functional near-infrared spectroscopy (fNIRS) surgical training |
| url | https://www.mdpi.com/2076-3425/15/4/387 |
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