RESUMEN
We know that experienced endoscopic surgeons, despite having extensive training, may make a rare but fatal mistake. Prof. Takeshi Ohdaira developed a device visualizing brain action potential to reflect the latent psychological instability of the surgeon. The Ohdaira system consists of three components: a real-time brain action potential measurement unit, a simulated abdominal cavity, and an intra-abdominal monitor. We conducted two psychological stress tests by using an artificial laparoscopic simulator and an animal model. There were five male subjects aged between 41 to 61 years. The psychological instability scores were considered to reflect, to some extent, the number of years of experience of the surgeon in medical care. However, very high inter-individual variability was noted. Furthermore, we discovered the following: 1) bleeding during simulated laparoscopic surgery--an episode generally considered to be psychological stress for the surgeon--did not form the greatest psychological stress; 2) the greatest psychological stress was elicited at the moment when the surgeon became faced with a setting in which his anatomical knowledge was lacking or a setting in which he presumed imminent bleeding; and 3) the excessively activated action potential of the brain possibly leads to a procedural error during surgery. A modified brain action potential measurement unit can reveal the latent psychological instability of surgeons that possibly leads to errors in surgical procedures.