Correlation of laparoscopic experience with differential functional brain activation: a positron emission tomography study with oxygen 15-labeled water.
OBJECTIVE
Regions of functional brain activation differ between novice and expert laparoscopists.


METHODS
We compared novice and expert laparoscopists using positron emission tomography (PET) during the peg transfer task of the McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) protocol. The first scan (rest) was performed with the subject's eyes closed. The second scan (video 1) was performed while watching a peg transfer video. The third scan (peg 1) was acquired during the peg transfer task. The forth scan (peg 2) was performed after practicing 15 minutes. The fifth scan (video 2) was performed after peg 2 as the subject watched a video clip of a laparoscopic partial nephrectomy. The sixth scan (peg 3) was conducted during the final peg transfer task after 15 more minutes of practice.


METHODS
Feinstein Institute for Medical Research.


METHODS
Five novice and 5 expert laparoscopists.


METHODS
Differences in brain activation as determined by changes in regional cerebral blood flow on PET scans with oxygen 15-labeled water.


RESULTS
The first analysis examined group differences between the 3 peg scans and the rest scan. The novice group had a significantly (P < .001) higher activation (with deactivation in the expert group) in the left precentral gyrus and insula and the right precuneus and inferior occipital gyrus. The second analysis compared the 2 video scans and the rest scan. In contrast to the expert group, the novices had significantly (P < .001) higher activation in the right precuneus and cuneus but deactivation in the bilateral posterior cerebellum.


CONCLUSIONS
This study demonstrates differential regional brain activation patterns between novice and expert laparoscopists during surgery-related motor and visual association tasks.
Smith Institute for Urology, North Shore-Long Island Jewish Health System, New Hyde Park, NY 11042, USA. bduty@nshs.edu
Brian
B
Duty
Sero
S
Andonian
Yilong
Y
Ma
Shichun
S
Peng
Edan
E
Shapiro
Vijay
V
Dhawan
Lee
L
Richstone
David
D
Eidelberg
Louis R
LR
Kavoussi
D000328:Adult; D000704:Analysis of Variance; D001921:Brain / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation; D002983:Clinical Competence; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010104:Oxygen Radioisotopes; D049268:Positron-Emission Tomography; D013647:Task Performance and Analysis
D010104:Oxygen Radioisotopes