Skills required to perform laparoscopic keyhole surgery can be significantly enhanced by applying electric neurostimulation during training, researchers at Lero, the Science Foundation Ireland Research Centre for Software, have found.

The study by a research team at Lero’s Esports Science Research Lab (ESRL) at the University of Limerick (UL) and the ASSERT centre at University College Cork found that medical students performed some surgical tasks significantly better when they wore a custom headset delivering transcranial Direct Current Stimulation (tDCS) than those who wore a headset but did not receive tDCS neurostimulation while performing the training tasks.

Lero and University of Limerick researchers Professor Mark Campbell and Dr Adam Toth said enhancing surgical skills is paramount to reducing surgery times and improving clinical outcomes.

“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,” Professor Campbell added.

While the testing and training sessions on 53 participants, 27 females and 26 males, conducted at the ASSERT surgical simulation lab at UCC found that males and females reacted similarly, the study found that not all surgical skills were improved by neurostimulation.

Dr Toth explained that 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,” added Dr Toth.

Dr Daniel Galvin, from the ASSERT centre, said: “We also found 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.”

Professor Campbell and the research team said 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 have already carried out extensive research into electric neurostimulation in the field of esports and following on from this, the team wished to investigate the application of these findings into other domains, notably surgery.