The physiological assessment to burden on the surgeon in LS using the 128 channels EEG

Hisae Aoki, MD¹, Toshiyuki Mori, MD, PhD², Hiromasa Yamashita, PhD³, Toshio Chiba, MD, PhD³, Akio Mori, PhD⁴. ¹Department of Surgery, Sanraku Hospital, ²Department of Surgery, Kyorin University, ³University Research Center (URC), Nihon University, ⁴College of Humanities and Sciences, Nihon University

Introduction: The laparoscopic surgery has been evolved by development of the various laparoscopic surgical systems, for example, the robotic surgical system or the 3-dimension laparoscopic surgery system. In addition, the laparoscopic instrument such as forceps and energy devices has been progressing developed. As a result, the evaluation of their usability should be required. In general 3D camera system has believed to be better than 2D camera system, however there is no report of proving advantage of the 3D camera by physiological assessment recoding during operating tasks. Multi-channel Electroencephalogram (EEG) is a well-known tool to assess the brain activity during tasks, and the beta band pattern changes in accordance to the brain activity  We used the 128 channel EEG to evaluate the surgeon’s brain activity  in laparoscopic surgery.

Method: The eight surgeons  performed standardized skill tasks(“Space pointing task (SPT)”, “Move the ring” and “Ligation” ) in the training box. In our study, 128 channel electroencephalograms were used.  Continuous EEG was recorded with a 128 channel EGI (Electrical Geodesics Inc.). The electroencephalogram was measured continuously while performing the tasks. After recording, these data were passed through a digital low pass filter (30 Hz) and a digital high pass filter (3 Hz) to investigate alpha beta and theta band patterns during tasks. Each band pattern, alpha(8-13Hz), beta(13-25Hz) and theta(4-8Hz) were analyzed. The each band activity was expressed as a percentage of the total power in each segment as 2D topography.

Result: There was no significant difference of beta band patterns between using 2D camera and 3D camera. In space pointing task, there was no significant difference of beta band patterns between novice group and expert group. However in performing the “Ligation” and “Move the ring”, significant differences of the beta band pattern between novice group and expert group were noted.

Conclusion: The 128 channels EEG can be the physiological evaluation to burden on the surgeons. When the new device is used in laparoscopic surgery, it might be possible to prove usability with beta band patterns using the 128 channels EEG. And the assessment on laparoscopic training progress might be possible.