Presentation Authors: Somayeh B Shafiei, Zaeem Lone*, Ahmed S. Elsayed, Naif A. Aldhaam, Zhe Jing, Israh Ibrahim, Khurshid A. Guru, Buffalo, NY
Introduction: Electroencephalogram (EEG) and detailed eye tracking in surgeons during complex, catastrophic events of robot-assisted surgery (RAS) is yet to be defined. In this study, we sought to explore the difference between surgeons' brain activity and eye gaze during RAS while encountering catastrophic intraoperative events (bleeding) and regular surgery.
Methods: Electroencephalogram (EEG) data (500 Hz) was recorded from 120 areas of the brain of one RAS surgeon while he performed 86 surgeries (three cases of intraoperative bleeding). The particiapnt's brain network integration and recruitment features were calculated using netowrk neuroscience algorithims. Integration refers to the probability that an area in the brain is in the same network community as areas from other cognitive systems (eg. the frontal lobe communicates with the occiptal lobe). Recruitment is the probability that an area in the brain is in the same network community as other areas from its own cognitive system (eg. communication within the frontal lobe).Eye tracking was recorded in 79 cases (2 cases of intraoperative bleeding). Eye tracking data was analyzed for three features: fixation, saccade, and divergence. Fixation is the period in which the surgeon's eyes are locked toward a specific object. Saccade is the eye tracking movement between fixations and measures attention. Divergence is a feature used to measure focus and is determined by considering the behavior of both eyes and calculating the difference between horizontal locations for each eye and taking the average across all observations within 1s.
Results: EEG data revealed that both Integration and Recruitment were higher in catastrophic than normal events suggesting decreased autonomy in brain activity. Eye tracking data revealed that the fixation rate was higher for procedures with bleeding compared to regular cases. The saccade rate was lower for procedures with bleeding compared to regular surgery suggesting increased attention. Divergence was lower in procedures with bleeding suggesting increased focus.
Conclusions: Brain integration and recruitment features may serve as informative metrics toward an evaluation of a surgeon's risk management ability. Eye tracking data revealed increased attention and focus during these catastrophic events.
Source of Funding: This work was supported by the Roswell Park Alliance Foundation.