Objective assessment of endoscopic surgical skills by analyzing direction-dependent dexterity using the Hiroshima University Endoscopic Surgical Assessment Device (HUESAD)

Abstract

Purpose. We evaluated our system of objectively assessing endoscopic surgical skills. Methods. We developed the Hiroshima University Endoscopic Surgical Assessment Device (HUESAD), which records the movement of the tip of an endoscopic instrument precisely. The orbits of experienced surgeons (expert group) and those of medical students (novice group) were evaluated by measuring the deviation from the ideal course on horizontal and vertical planes. These data were integrated with the time taken to move the tip of an endoscopic instrument between a distal side pole (A) and a proximal side pole (C) (Task 1), and between a left side pole (D) and a right side pole (B) (Task 2). Results. The integrated deviation of the expert group was signifi cantly lower than that of the novice group on both the horizontal and vertical planes in Task 1 (P = 0.0004, P = 0.009) and Task 2 (P < 0.0001, P = 0.0002). Thus, the spatial perception of experts was signifi cantly better than that of novices. We also found that the direction of the scope and the movement of the endoscopic instrument were related to diffi culties in spatial perception for both experts and novices. HUESAD detected and resolved these differences based on the directions of the scope and movement of the endoscopic instruments. Conclusions. The HUESAD is a reliable system for assessing a surgeon's dexterity, based on direction and movement. It helps us to attain a higher degree of accuracy and to create an ideal setting for optimal endoscopic surgery.

EVA: Laparoscopic Instrument Tracking Based on Endoscopic Video Analysis for Psychomotor Skills Assessment

“…EVA showed good construct validity both for 2D and 3D metrics. Time, path length, and depth are common parameters, which have been validated in many clinical studies [11,[44][45][46][47][48]. Average speed and acceleration are less widespread metrics, but also showed good discriminative scores [11,44,49].…”

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

“…Typically, this assessment requires the presence of a trained supervisor, and the definition of clear, structured checklists are necessary [28,53]. Table 6 shows the most widespread HMT capture systems for surgical assessment identified in the literature [44][45][46][47][48][49][50][51][52][53][54][55][88][89][90][91]. Their classification can be done according to the nature of the acquired information.…”

“…In a majority, they are used to record both the position (x, y, z coordinates) and orientation (yaw, pitch and roll) of the surgical instruments. In this review, the following systems are considered: ADEPT [92], ICSAD [52] (which measures hand movements rather than instrumenta position), CELTS [45], Zebris [48], TrEndo [93], ARH [94], HUESAD [47] and BlueDRAGON (which also measures forcé parameters) [95].…”

“…Most frequently, HMT systems are used on box trainers, where the performance of surgeons in basic and advanced reproducible tasks is recorded [45][46][47][48]53]. This trend can easily be explained, since there is a need to certify a surgeon's psychomotor skills before allowing him/her to opérate on a patient.…”

Systems and technologies for objective evaluation of technical skills in laparoscopic surgery

“…The Hiroshima University Endoscopy Surgical Assessment Device (HUESAD) was designed to evaluate the smoothness in the use of laparoscopic instruments (11,34,35). It consists of an accurate tracking device for real laparoscopic instruments, an experimental table, a monitor, and a personal computer.…”