Measuring hand movement for suturing skill assessment: A simulation-based study

Objective and Automated Quantification of Instrument Handling for Open Surgical Suturing Skill Assessment: A Simulation-Based Study

“…The study demonstrated potential in their measure by distinguishing expert and novice performance, but the researchers note that their small sample size may affect the generalizability of their results. Similarly, a previous study on the SutureCoach found metrics applied to rotational hand motions were better suited to differentiate clinical expertise than metrics applied to transitional hand motions [29] . We can expect that applying complex metrics to rotational motion may better assess instrument handling motion quality pertinent to skilled suturing.…”

“…A force/torque sensor measures membrane forces during suturing, and two inertial measurement units (IMUs) are placed on a subject's hand and wrist. A previous study on our simulator analyzed hand motions obtained from the IMU on the same dataset presented in this study [29] . Specifically, this study examines data obtained from two electromagnetic position and orientation sensors (Ascension trakSTAR Model 180, Northern Digital Inc.), recording x, y, and z Cartesian sensor-frame coordinates and azimuth, elevation, roll, and quaternion orientation at a rate of 100 Hz, are attached to both handles of a needle driver (Mayo-Hegar, 8”).…”

“…Number of Rotations (NoR): Building upon the number of rolls metric previously applied to measure hand movements on the SutureCoach [29] , NoR sums the number of changes in the direction of rotation through roll-axis angular velocity to measure deliberate rotations during suturing performance. A deliberate change in rotation requires an APL greater than 3.6 degrees — 1% of the full 360-degree rotation — until the next rotation occurs.…”

Evaluating Smoothness of Force for Surgical Skill Assessment

“…Our study investigates the applicability of well-established motion smoothness metrics [8], [10], [11] to the domain of force measurement, specifically within the context of suturing. Notably, Trejos et al [7] and Balasubramanian et al [11] recognized the parallels between force and kinematic profiles, though the latter emphasized the potential limitations due to inherent differences in the nature of the data.…”

“…This study presents and evaluates new metrics that measure force during simulated surgical suturing that are inspired by measures of smoothness of motion. These metrics are evaluated on a large dataset encompassing several levels of clinical expertise performing tasks on the SutureCoach platform [8]. The SutureCoach interfaces intricate sensors for a holistic evaluation of open vascular suturing skills on a clock face pattern modeled after the Fundamentals of Vascular Surgery (FVS) [9].…”