Editorial Perspective: Robot-Assisted Evaluation of Robotic Surgical Skills

Cheng, Shih-Chun; Chao, Yin‐Kai

doi:10.1245/s10434-022-12062-6

Cited by 5 publications

(5 citation statements)

References 17 publications

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“…Assessment tools are inherently subjective and limited by observer bias, time and energy constraints, poor scalability, and limited actionable feedback. 4,[10][11][12][13][14] These limitations, in combination with the availability of new objective measurements, necessitate further study into the future of surgical assessments. Surgical data science, the field that has emerged from the analysis of OPIs, is young but includes exciting preliminary work in urology, general surgery, bariatrics, and thoracic surgery.…”

Section: Discussionmentioning

confidence: 99%

Ratio of Economy of Motion: A New Objective Performance Indicator to Assign Consoles During Dual-Console Robotic Proctectomy

Devin

Gillani

Shields

et al. 2023

The American Surgeon™

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Background Our group investigates objective performance indicators (OPIs) to analyze robotic colorectal surgery. Analyses of OPI data are difficult in dual-console procedures (DCPs) as there is currently no reliable, efficient, or scalable technique to assign console-specific OPIs during a DCP. We developed and validated a novel metric to assign tasks to appropriate surgeons during DCPs. Methods A colorectal surgeon and fellow reviewed 21 unedited, dual-console proctectomy videos with no information to identify the operating surgeons. The reviewers watched a small number of random tasks and assigned “attending” or “trainee” to each task. Based on this sampling, the remainder of task assignments for each procedure was extrapolated. In parallel, we applied our newly developed OPI, ratio of economy of motion (rEOM), to assign consoles. Results from the 2 methods were compared. Results A total of 1811 individual surgical tasks were recorded during 21 proctectomy videos. A median of 6.5 random tasks (137 total) were reviewed during each video, and the remainder of task assignments were extrapolated based on the 7.6% of tasks audited. The task assignment agreement was 91.2% for video review vs rEOM, with rEOM providing ground truth. It took 2.5 hours to manually review video and assign tasks. Ratio of economy of motion task assignment was immediately available based on OPI recordings and automated calculation. Discussion We developed and validated rEOM as an accurate, efficient, and scalable OPI to assign individual surgical tasks to appropriate surgeons during DCPs. This new resource will be useful to everyone involved in OPI research across all surgical specialties.

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Section: Discussionmentioning

confidence: 99%

Ratio of Economy of Motion: A New Objective Performance Indicator to Assign Consoles During Dual-Console Robotic Proctectomy

Devin

Gillani

Shields

et al. 2023

The American Surgeon™

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“…Operative reports dictated by surgeons have been shown to lack accuracy and are subject to bias 2–5 . Using descriptors such as ‘hostile abdomen’, ‘extensive scar tissue’, or ‘extremely difficult dissection’ are inherently subjective.…”

Section: Introductionmentioning

confidence: 99%

“…Operative reports dictated by surgeons have been shown to lack accuracy and are subject to bias [2][3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

Quantification of surgical workflow during robotic proctectomy

Gillani,

Rupji,

Devin

et al. 2024

Robotics Computer Surgery

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BackgroundSurgical workflow assessments offer insight regarding procedure variability. We utilised an objective method to evaluate workflow during robotic proctectomy (RP).MethodsWe annotated 31 RPs and used Spearman's correlation to measure the correlation of step time and step visit frequency with console time (CT) and total operative time (TOT).ResultsStrong correlations were seen with CT and step times for inferior mesenteric vein dissection and ligation (ρ = 0.60, ρ = 0.60), lateral‐to‐medial splenic flexure mobilisation (SFM) (ρ = 0.63), left rectal dissection (ρ = 0.64) and mesorectal division (ρ = 0.71). CT correlated strongly with medial‐to‐lateral (ρ = 0.75) and supracolic SFM visit frequency (ρ = 0.65). TOT correlated strongly with initial exposure time (ρ = 0.60), and medial‐to‐lateral (ρ = 0.67) and supracolic SFM visit frequency (ρ = 0.65).ConclusionThis study correlates surgical steps with CT and TOT through standardised annotation, providing an objective approach to quantify workflow.

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“…Robotic surgery was introduced due to its improved dexterity, haptics, and visualization, and was also believed to create an ergonomically sound environment compared to traditional open or laparoscopic surgery. 3 Despite robotic surgery proving to be a more precise and efficient procedure, 4 there are possible negative effects on the surgeon's physical health and longevity. Muscular fatigue and injury in surgeons who operate robotically are very common due to repetitive movements as well as posture while sitting at the console.…”

Section: Introductionmentioning

confidence: 99%

“…Despite robotic surgery proving to be a more precise and efficient procedure, 4 there are possible negative effects on the surgeon’s physical health and longevity. Muscular fatigue and injury in surgeons who operate robotically are very common due to repetitive movements as well as posture while sitting at the console.…”

Section: Introductionmentioning

confidence: 99%

Assessing Muscular Pain and Ergonomics Among Robotic Surgeons in China: A Validation

Saikali,

Patel,

Mascarenhas

et al. 2024

Surg Innov

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Introduction Robotic surgery has transformed minimally invasive procedures, offering precision and efficiency. However, the ergonomic aspects of robotic consoles and their impact on surgeon health remain understudied. This review investigates the burden of ergonomics and muscle fatigue among robotic surgeons in China, comparing the findings to a multinational study. Methodology A literature review identified themes related to physical discomfort in robotic surgery. A questionnaire was administered to Chinese robotic surgeons, yielding 40 responses. The study assessed demographic characteristics, surgeon experience, ergonomic practices, reported discomfort, and pain-relief mechanisms. Results The study revealed that most surgeons experienced shoulder and neck pain, with mixed opinions on whether robotic surgery was the primary cause. Stretching exercises were commonly used for pain relief. Surgeons believed that case volume and surgery duration contributed to discomfort. Comparisons with a multinational study suggested potential demographic and experience-related differences. Conclusion While the study has limitations, including a small sample size and potential translation issues, it underscores the importance of addressing ergonomic concerns and providing proper training to robotic surgeons to ensure their well-being and longevity in the field. Further research with larger cohorts and platform-specific analyses is warranted.

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Editorial Perspective: Robot-Assisted Evaluation of Robotic Surgical Skills

Cited by 5 publications

References 17 publications

Ratio of Economy of Motion: A New Objective Performance Indicator to Assign Consoles During Dual-Console Robotic Proctectomy

Ratio of Economy of Motion: A New Objective Performance Indicator to Assign Consoles During Dual-Console Robotic Proctectomy

Quantification of surgical workflow during robotic proctectomy

Assessing Muscular Pain and Ergonomics Among Robotic Surgeons in China: A Validation

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