Juan A Sánchez-Margallo1, Francisco M Sánchez-Margallo2, José B Pagador Carrasco3, Ignacio Oropesa García4, Enrique J Gómez Aguilera4, José Moreno del Pozo5. 1. Unidad de Bioingeniería y Tecnologías Sanitarias, Centro de Cirugía de Mínima Invasión Jesús Usón, Cáceres, España. Electronic address: jasanchez@ccmijesususon.com. 2. Unidad de Laparoscopia, Centro de Cirugía de Mínima Invasión Jesús Usón, Cáceres, España. 3. Unidad de Bioingeniería y Tecnologías Sanitarias, Centro de Cirugía de Mínima Invasión Jesús Usón, Cáceres, España. 4. Grupo de Bioingeniería y Telemedicina, Universidad Politécnica de Madrid, Madrid, España; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, España. 5. Laboratorio de Robótica y Visión Artificial, Universidad de Extremadura, Cáceres, España.
Abstract
INTRODUCTION: The objective of this study is to assess the usefulness of an evaluation system of surgical skills based on motion analysis of laparoscopic instruments. METHOD: This system consists of a physical laparoscopic simulator and a tracking and assessment system of technical skills in laparoscopy. Six surgeons with intermediate experience (between 1 and 50 laparoscopic surgeries) and 5 experienced surgeons (more than 50 laparoscopic surgeries) took part in this study. All participants were right-handed. The subjects performed 3 repetitions of a cutting task on synthetic tissue with the right hand, dissection of a gastric serous layer, and a suturing task in the dissection previously done. Objective metrics such as time, path length, speed of movements, acceleration and motion smoothness were analyzed for the instruments of each hand. RESULTS: In the cutting task, experienced surgeons show less acceleration (P=.014) and a smoother motion (P=.023) using the scissors. Regarding the dissection activity, experienced surgeons need less time (P=.006) and less length with both instruments (P=.006 for dissector and P=.01 for scissors). In the suturing task, experienced surgeons require less time (P=.037) and distance travelled (P=.041) by the dissector. CONCLUSIONS: This study shows the usefulness of the evaluation system for the cutting, dissecting, and suturing tasks. It represents a significant step in the development of advanced systems for training and assessment of surgical skills in laparoscopic surgery.
INTRODUCTION: The objective of this study is to assess the usefulness of an evaluation system of surgical skills based on motion analysis of laparoscopic instruments. METHOD: This system consists of a physical laparoscopic simulator and a tracking and assessment system of technical skills in laparoscopy. Six surgeons with intermediate experience (between 1 and 50 laparoscopic surgeries) and 5 experienced surgeons (more than 50 laparoscopic surgeries) took part in this study. All participants were right-handed. The subjects performed 3 repetitions of a cutting task on synthetic tissue with the right hand, dissection of a gastric serous layer, and a suturing task in the dissection previously done. Objective metrics such as time, path length, speed of movements, acceleration and motion smoothness were analyzed for the instruments of each hand. RESULTS: In the cutting task, experienced surgeons show less acceleration (P=.014) and a smoother motion (P=.023) using the scissors. Regarding the dissection activity, experienced surgeons need less time (P=.006) and less length with both instruments (P=.006 for dissector and P=.01 for scissors). In the suturing task, experienced surgeons require less time (P=.037) and distance travelled (P=.041) by the dissector. CONCLUSIONS: This study shows the usefulness of the evaluation system for the cutting, dissecting, and suturing tasks. It represents a significant step in the development of advanced systems for training and assessment of surgical skills in laparoscopic surgery.
Authors: Karl-Friedrich Kowalewski; Jonathan D Hendrie; Mona W Schmidt; Carly R Garrow; Thomas Bruckner; Tanja Proctor; Sai Paul; Davud Adigüzel; Sebastian Bodenstedt; Andreas Erben; Hannes Kenngott; Young Erben; Stefanie Speidel; Beat P Müller-Stich; Felix Nickel Journal: Surg Endosc Date: 2016-09-07 Impact factor: 4.584