Assessing system operation skills in robotic surgery trainees

Abstract

Background With increased use of robotic surgery in specialties including urology, development of training methods has also intensified. However, current approaches lack the ability of discriminating operational and surgical skills. Methods An automated recording system was used to longitudinally (monthly) acquire instrument motion/telemetry and video and for 4 basic surgical skills -- suturing, manipulation, transection, and dissection. Statistical models were then developed to discriminate the human-machine skill differences between practicing expert surgeons and trainees. Results Data from 6 trainee and 2 experts was analyzed to validate the first ever statistical models of operational skills, and demonstrate classification with very high accuracy (91.7% for masters, and 88.2% for camera motion) and sensitivity. Conclusions We report on our longitudinal study aimed at tracking robotic surgery trainees to proficiency, and methods capable of objectively assessing operational and technical skills that would be used in assessing trainee progress at the participating institutions.

Conventional Laparoscopic vs Robotic Training: Which is Better for Naive Users? A Randomized Prospective Crossover Study

“…At least for RS, the complexity of the human-machine interface can contribute significantly toward long learning curves that are seen even for laparoscopically trained surgeons. 2 A study of actual clinicians undergoing training has found that after 90 robotic cases, there is a plateau of the mean overall score on the dVSSS. 26 Our data indicate that the initial learning curves for both RT and CT are similar for basic manipulative tasks in naive users in laboratory conditions.…”

“…1,2 The da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA) is the only US Food and Drug Administration-approved surgical robotic assistant in the United States. It is widely considered to have the potential to compensate for technical drawbacks inherent in conventional laparoscopic surgery (CLS), such as limited degree of freedom, 2-dimensional (2D) vision, and fulcrum and pivoting effects.…”

Objective Assessment of Surgical Technical Skill and Competency in the Operating Room

“…In the case of robotic surgery, rich stereo video and tool movement data can be captured completely transparently in both the training laboratory and the operating room (76, 78–80, 85, 86, 111). In nonrobotic cases, tool motion data in the training laboratory can be captured by affixing a variety of sensors to the instruments, for example, accelerometers, strain gauges, and electromagnetic or optical trackers (46, 66, 67, 72, 73, 86, 87, 112, 113).…”

“…Principal components that explained the majority of variation in the data were used as nonspecific summary features for OCASE-T in some studies (69, 70, 73, 79). Generic descriptors of tool motion efficiency, such as time, path length, or movements, which may be easily computed on any surgical platform, were used for OCASE-T in several other studies (78, 79, 81, 82, 84, 85, 93, 97). Descriptors of other measures of tool motion, such as force, were used as features for OCASE-T in a few studies (54, 70, 71, 83, 88).…”

A computer vision-based approach to grade simulated cataract surgeries

“…Zhang et al [50] develops relative HMM utilizing to achieve more consistent relative rankings. Ahmidi et al [3] and Kumar et al [31] developed automated surgical skill assessment system using eye-tracking and toolmotion data; however, they used an electromagnetic tracker to record the surgeon's tool which is not available to all the trainees.…”