Researchers are currently delving into the possibilities of brain-computer interface technologies in surgical training to enhance patient safety.
The team at Imperial College London is studying brain activity of surgeons for signs of cognitive overload and suggests techniques could be used to flag warning signs during surgery.
The research team, spearheaded by Daniel Leff, a senior researcher and consultant breast surgeon at Imperial College Healthcare NHS Trust, explores the complex mechanisms of surgeons’ brains within operating rooms.
Their objective is to reveal signs of cognitive overload that might compromise patient safety.
Mary Goble is a first-year student specialising in surgery. By monitoring her brain activity during a simulated appendectomy at the Surgical Innovation Centre at St Mary’s Hospital in Paddington, west London, researchers aim to identify indicators of cognitive overload that could jeopardise patient wellbeing.
The initiative seeks to improve surgical performance and pave the way for future real-time brain activity monitoring applications in operation theatres.
The cap worn by Mary uses functional near-infrared spectroscopy (fNIRS), a non-invasive technique to measure changes in blood oxygenation in the brain – a proxy for the underlying neural activity.
Previously, the team has shown that novices had greater pre-frontal brain activity than experienced doctors when performing surgery.
They also found that pre-frontal activity was disrupted more easily in doctors whose performance dipped during stressful situations.
Using fNIRS, the study delves into changes in blood oxygenation levels that correspond with neural activity.
Despite Mary’s outward composure during the simulation, the fNIRS data unveiled the intense mental strain she experienced while juggling multiple challenges simultaneously.
This monitoring method offers a non-invasive approach to understanding the cognitive load on surgeons, potentially reshaping the approach to surgical training and enhancing patient safety.
However, neuro-augmentation applications in surgery, such as transcranial direct current stimulation (tDCS), face scepticism.
Daniel Leff emphasises the importance of framing these innovations as tools to improve doctor performance and ensure patient safety to gain wider acceptance.
The goal, he stresses, is not to assess capability but to support surgeons in delivering their best work under pressure.
While the current study does not provide real-time brain activity readouts during actual surgeries, it lays the groundwork for future advancements in brain-computer-interface technologies.
As researchers continue to explore possibilities, including harmless monitoring of cognitive load via fNIRS and potential performance enhancement through tDCS, the prospect of real-time interventions to assist surgeons during critical moments edges closer to reality.
This research heralds a new era in surgical training and patient care, underscoring the pivotal role of technology in revolutionising medical practices.
The exploration of brain-computer interface technologies at Imperial College London signifies a significant stride toward understanding and mitigating cognitive overload in surgeons.
