Neuroenhancement of future surgeons – Opinions from students, surgeons and patients

摘要

In recent years, there has been a substantial drive towards adoption of technological innovation in surgical training and practice, with The Royal College of Surgeons setting up “The Commission on the Future of Surgery” [[1]Surgeons RC of. Future of surgery. 2017Google Scholar] to identify novel technologies likely to change care. It recognises innovations in surgical training and, in this regard, a number of research groups are exploring the role of neuroenhancement [2Ciechanski P. Cheng A. Lopushinsky S. Hecker K. Gan L.S. Lang S. et al.Effects of transcranial direct-current stimulation on neurosurgical skill acquisition: a randomized controlled trial.World Neurosurg. 2017; 108 (e4): 876-884https://doi.org/10.1016/j.wneu.2017.08.123Crossref PubMed Scopus (18) Google Scholar, 3Ciechanski P. Cheng A. Damji O. Lopushinsky S. Hecker K. Jadavji Z. et al.Effects of transcranial direct-current stimulation on laparoscopic surgical skill acquisition: a randomized clinical trial.BJS Open. 2018; 2: 70-78https://doi.org/10.1016/j.brs.2017.01.555Abstract Full Text Full Text PDF PubMed Google Scholar, 4Ciechanski P. Kirton A. Wilson B. Williams C.C. Anderson S.J. Cheng A. et al.Electroencephalography correlates of transcranial direct-current stimulation enhanced surgical skill learning: a replication and extension study.Brain Res. 2019; 1725: 146445https://doi.org/10.1016/j.brainres.2019.146445Crossref PubMed Scopus (12) Google Scholar, 5Cox M.L. Deng Z De Palmer H. Watts A. Beynel L. Young J.R. et al.Utilizing transcranial direct current stimulation to enhance laparoscopic technical skills training: a randomized controlled trial.Brain Stimul. 2020; 13: 863-872https://doi.org/10.1016/j.brs.2020.03.009Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar, 6Ashcroft J. Patel R. Woods A.J. Darzi A. Singh H. Leff D.R. Prefrontal transcranial direct-current stimulation improves early technical skills in surgery.Brain Stimul. 2020; 13: 1834-1841https://doi.org/10.1016/j.brs.2020.10.013Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar]. Emerging evidence suggests that transcranial direct-current stimulation (tDCS) improves laparoscopic skills and neurosurgical performance [2Ciechanski P. Cheng A. Lopushinsky S. Hecker K. Gan L.S. Lang S. et al.Effects of transcranial direct-current stimulation on neurosurgical skill acquisition: a randomized controlled trial.World Neurosurg. 2017; 108 (e4): 876-884https://doi.org/10.1016/j.wneu.2017.08.123Crossref PubMed Scopus (18) Google Scholar, 3Ciechanski P. Cheng A. Damji O. Lopushinsky S. Hecker K. Jadavji Z. et al.Effects of transcranial direct-current stimulation on laparoscopic surgical skill acquisition: a randomized clinical trial.BJS Open. 2018; 2: 70-78https://doi.org/10.1016/j.brs.2017.01.555Abstract Full Text Full Text PDF PubMed Google Scholar, 4Ciechanski P. Kirton A. Wilson B. Williams C.C. Anderson S.J. Cheng A. et al.Electroencephalography correlates of transcranial direct-current stimulation enhanced surgical skill learning: a replication and extension study.Brain Res. 2019; 1725: 146445https://doi.org/10.1016/j.brainres.2019.146445Crossref PubMed Scopus (12) Google Scholar, 5Cox M.L. Deng Z De Palmer H. Watts A. Beynel L. Young J.R. et al.Utilizing transcranial direct current stimulation to enhance laparoscopic technical skills training: a randomized controlled trial.Brain Stimul. 2020; 13: 863-872https://doi.org/10.1016/j.brs.2020.03.009Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar]. Similarly, performance scores on complex surgical bimanual tasks improve with tDCS when compared to sham [[6]Ashcroft J. Patel R. Woods A.J. Darzi A. Singh H. Leff D.R. Prefrontal transcranial direct-current stimulation improves early technical skills in surgery.Brain Stimul. 2020; 13: 1834-1841https://doi.org/10.1016/j.brs.2020.10.013Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar]. Although these observations are encouraging, a number of impo