Erlend Fagertun Hofstad1,2, Cecilie Våpenstad1,2,3, Lars Eirik Bø1,2,3, Thomas Langø1,2, Esther Kuhry4,5, Ronald Mårvik2,4,5,6. 1. a Department of Medical Technology , SINTEF Technology and Society , Trondheim , Norway. 2. b The Norwegian National Advisory Unit for Ultrasound and Image-Guided Therapy, St. Olavs Hospital-Trondheim University Hospital , Trondheim , Norway. 3. c Department of Circulation and Medical Imaging, Faculty of Medicine , Norwegian University of Science and Technology (NTNU) , Trondheim , Norway. 4. d Department of Cancer Research and Molecular Medicine, Faculty of Medicine , Norwegian University of Science and Technology (NTNU) , Trondheim , Norway. 5. e Department of Surgery , St. Olavs Hospital, Trondheim University Hospital , Trondheim , Norway. 6. f National Center for Advanced Laparoscopic Surgery, St. Olavs Hospital, Trondheim University Hospital , Trondheim , Norway.
Abstract
BACKGROUND: A high level of psychomotor skills is required to perform minimally invasive surgery (MIS) safely. To be able to measure these skills is important in the assessment of surgeons, as it enables constructive feedback during training. The aim of this study was to test the validity of an objective and automatic assessment method using motion analysis during a laparoscopic procedure on an animal organ. MATERIAL AND METHODS: Experienced surgeons in laparoscopy (experts) and medical students (novices) performed a cholecystectomy on a porcine liver box model. The motions of the surgical tools were acquired and analyzed by 11 different motion-related metrics, i.e., a total of 19 metrics as eight of them were measured separately for each hand. We identified for which of the metrics the experts outperformed the novices. RESULTS: In total, two experts and 28 novices were included. The experts achieved significantly better results for 13 of the 19 instrument motion metrics. CONCLUSIONS: Expert performance is characterized by a low time to complete the cholecystectomy, high bimanual dexterity (instrument coordination), a limited amount of movement and low measurement of motion smoothness of the dissection instrument, and relatively high usage of the grasper to optimize tissue positioning for dissection.
BACKGROUND: A high level of psychomotor skills is required to perform minimally invasive surgery (MIS) safely. To be able to measure these skills is important in the assessment of surgeons, as it enables constructive feedback during training. The aim of this study was to test the validity of an objective and automatic assessment method using motion analysis during a laparoscopic procedure on an animal organ. MATERIAL AND METHODS: Experienced surgeons in laparoscopy (experts) and medical students (novices) performed a cholecystectomy on a porcine liver box model. The motions of the surgical tools were acquired and analyzed by 11 different motion-related metrics, i.e., a total of 19 metrics as eight of them were measured separately for each hand. We identified for which of the metrics the experts outperformed the novices. RESULTS: In total, two experts and 28 novices were included. The experts achieved significantly better results for 13 of the 19 instrument motion metrics. CONCLUSIONS: Expert performance is characterized by a low time to complete the cholecystectomy, high bimanual dexterity (instrument coordination), a limited amount of movement and low measurement of motion smoothness of the dissection instrument, and relatively high usage of the grasper to optimize tissue positioning for dissection.
Authors: Jani Koskinen; Antti Huotarinen; Antti-Pekka Elomaa; Bin Zheng; Roman Bednarik Journal: Int J Comput Assist Radiol Surg Date: 2021-12-15 Impact factor: 2.924