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Transcranial direct-current stimulation (tDCS) can improve force and accuracy in motor tasks but research in surgery is limited to open and laparoscopic tasks in students. More recently, robotic surgery has gained traction and is now the most common approach for certain procedures (e.g. prostatectomy). Early-phase robotic suturing performance is dependent on prefrontal cortex (PFC) activation, and this study aimed to determine whether performance can be improved with prefrontal tDCS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifteen surgical residents were randomized to either active then sham tDCS or sham then active tDCS, in two counterbalanced sessions in a double-blind crossover study. Within each session, participants performed a robotic suturing task repeated in three blocks: pre-, intra- and post-tDCS. During the intra-tDCS block, participants were randomized to either active tDCS (2\u00a0mA for 15\u00a0min) to the PFC or sham tDCS. Primary outcome measures of technical quality included KTS and error scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significantly faster completion times were observed longitudinally, regardless of active (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) or sham stimulation (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). KTS was greater following active compared to sham stimulation (median: active\u2009=\u200944.35\u00a0N vs. sham\u2009=\u200927.12\u00a0N,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). A significant reduction in error scores from \u201cpre-\u201d to \u201cpost-\u201d (<jats:italic>p<\/jats:italic>\u2009=\u20090.029) were only observed in the active group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>tDCS could reduce error and enhance KTS during robotic suturing and warrants further exploration as an adjunct to robotic surgical training.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00464-021-08823-1","type":"journal-article","created":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T16:02:44Z","timestamp":1635782564000},"page":"4803-4814","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Neuroenhancement of surgeons during robotic suturing"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2386-0102","authenticated-orcid":false,"given":"Ronak","family":"Patel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Suwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Kinross","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"von Roon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Woods","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ara","family":"Darzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsimrat","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Richard","family":"Leff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,1]]},"reference":[{"key":"8823_CR1","doi-asserted-by":"crossref","unstructured":"van der Schatte Olivier RH, Van\u2019t Hullenaar CDP, Ruurda JP, Broeders IAMJ (2009) Ergonomics, user comfort, and performance in standard and robot-assisted laparoscopic surgery. 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