Rating of camera navigation skills in colorectal surgery

Huettl, Florentine; Lang, Hauke; Paschold, M.; Watzka, Felix; Wachter, Nicolas; Hensel, B.; Kneist, W.; Huber, Tobias

doi:10.1007/s00384-020-03543-9

Cited by 5 publications

(5 citation statements)

References 20 publications

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“…Another possibility would be to adjust for poor camera navigation in the evaluation of surgical performance, due to the laparoscopic camera navigation scoring system by Huettl et. al [ 36 ]…”

Section: Discussionmentioning

confidence: 99%

How can surgical skills in laparoscopic colon surgery be objectively assessed?—a scoping review

et al. 2021

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Background In laparoscopic colorectal surgery, higher technical skills have been associated with improved patient outcome. With the growing interest in laparoscopic techniques, pressure on surgeons and certifying bodies is mounting to ensure that operative procedures are performed safely and efficiently. The aim of the present review was to comprehensively identify tools for skill assessment in laparoscopic colon surgery and to assess their validity as reported in the literature. Methods A systematic search was conducted in EMBASE and PubMed/MEDLINE in May 2021 to identify studies examining technical skills assessment tools in laparoscopic colon surgery. Available information on validity evidence (content, response process, internal structure, relation to other variables, and consequences) was evaluated for all included tools. Results Fourteen assessment tools were identified, of which most were procedure-specific and video-based. Most tools reported moderate validity evidence. Commonly not reported were rater training, assessment correlation with variables other than training level, and validity reproducibility and reliability in external educational settings. Conclusion The results of this review show that several tools are available for evaluation of laparoscopic colon cancer surgery, but few authors present substantial validity for tool development and use. As we move towards the implementation of new techniques in laparoscopic colon surgery, it is imperative to establish validity before surgical skill assessment tools can be applied to new procedures and settings. Therefore, future studies ought to examine different aspects of tool validity, especially correlation with other variables, such as patient morbidity and pathological reports, which impact patient survival.

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Section: Discussionmentioning

confidence: 99%

How can surgical skills in laparoscopic colon surgery be objectively assessed?—a scoping review

et al. 2021

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“…Moreover, a skilled camera assistant should anticipate the surgeon's field of focus for every step in a surgical procedure, requiring thorough experience in all routinely performed surgeries. Poor LCN (e.g., horizon alignment failure, target out of view, excessive zoom‐in/out, instrument collisions, fogged/stained lens, and failure to achieve a stable view) can interfere with the flow of the operation, resulting in frustration for the surgeon and prolongation of operating time, compromising patient safety by increasing the risk of surgical errors 1‐5 …”

Section: Introductionmentioning

confidence: 99%

“…Poor LCN (e.g., horizon alignment failure, target out of view, excessive zoom-in/out, instrument collisions, fogged/stained lens, and failure to achieve a stable view) can interfere with the flow of the operation, resulting in frustration for the surgeon and prolongation of operating time, compromising patient safety by increasing the risk of surgical errors. [1][2][3][4][5] LCN is a complex psychomotor task requiring visual-spatial ability, hand-eye coordination, and assistant psychophysical endurance that requires significant training to achieve proficiency. [5][6][7] Counterintuitively, LCN for CLS often is performed by less experienced surgeons as residents, fellows, young consultants, or even attending physicians with no surgical expertise.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5] LCN is a complex psychomotor task requiring visual-spatial ability, hand-eye coordination, and assistant psychophysical endurance that requires significant training to achieve proficiency. [5][6][7] Counterintuitively, LCN for CLS often is performed by less experienced surgeons as residents, fellows, young consultants, or even attending physicians with no surgical expertise. This leads to an increase in surgical duration, 8,9 with an increase in cost for the hospital.…”

Section: Introductionmentioning

confidence: 99%

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Quality of laparoscopic camera navigation in robot‐assisted versus conventional laparoscopic surgery for rectal cancer: An analysis of surgical videos through a video processing computer software

Kim

Piozzi

Kwak

et al. 2022

Robotics Computer Surgery

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Background To compare laparoscopic camera navigation (LCN) quality between robot‐assisted laparoscopic surgery (RALS) and conventional laparoscopic surgery (CLS). Methods 20 recordings were selected by propensity score matching and subjected to Python® software to generate single frames at one second intervals. For each frame, the pixel where the camera should be centred, based on instrument position, current action (dissection/haemostasis/traction) in the frame, was detected. LCN quality was reviewed by two independent surgeons to evaluate erroneous LCN. Results RALS had higher incidence of centred views (83.1 ± 4.02% vs. 76.0 ± 2.38%, p < 0.05) and a shorter distance between actual and optimal frame centres (123.3 ± 9.8 vs. 144.8 ± 13.9, p < 0.05) compared to CLS. Erroneous camera navigations were more frequent in CLS regarding total time of horizontal alignment failure (2.1 ± 2.2 vs. 6.0 ± 5.4 min, p = 0.063) and number of excessive zoom‐in visualization (0.1 ± 0.3 vs. 1.9 ± 1.4, p = 0.003). Conclusions RALS provided higher LCN quality than did CLS, emphasising the benefits of a surgeon‐controlled view.

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“…Despite the significant developments in quality of laparoscopes, surgeons still encounter inadequate visualization of the surgical field on a daily basis [7][8][9]. The main reason is the fact that camera handling is entrusted to a camera assistant, which is often the least experienced team member in the operating room [10]. Inexperience of the camera assistant can result in more undesired camera movements, failure of centering the surgical field, disruption of the anatomical horizon and increased blurring of the lens, affecting the flow of a surgical procedure [11].…”

Section: Introductionmentioning

confidence: 99%

Image-based laparoscopic camera steering versus conventional steering: a comparison study

et al. 2022

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In the last 2 decades, multiple robotic camera holders have been developed to improve camera steering during laparoscopic surgery. A new image-based steering method has been developed for more intuitive camera control. In this article, the efficiency and user experience of image-based steering were compared to conventional steering methods. Four participants (two senior surgical registrars, one junior surgical registrar and a technical medicine student) were enrolled in this study. All participants performed multiple camera steering exercises with three different steering modalities in randomized order: image-based, joystick and manual camera steering. Steering of the laparoscope was evaluated by execution time and with the SMEQ and NASA-TLX questionnaires to analyze user experience. A total of 267 camera steering exercises were performed. The analyzed data showed a significantly shorter execution time for manual camera steering compared to image-based robotic steering (p = 0.001) and joystick robotic steering (p = 0.001). The participants reported the lowest user experience with joystick camera steering. The results of the questionnaires showed no significant difference in all subscales of user experience for image-based and manual camera steering. Manual camera steering resulted in significantly higher perceived physiological workload scores (M = 30.0, IQR = 27.5) compared to image-based (M = 10, IQR = 5.0) and joystick camera steering (M = 15.0, IQR = 10.0). Manual control of the laparoscope remains the fastest steering method at the expense of a high physical workload. Using image-based camera steering is a viable alternative to the current joystick control of robotic camera holders, as it improves speed and user experience. The study results suggest that optimisation of robotic camera steering with algorithms based on image analysis is a promising technology.

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Rating of camera navigation skills in colorectal surgery

Cited by 5 publications

References 20 publications

How can surgical skills in laparoscopic colon surgery be objectively assessed?—a scoping review

How can surgical skills in laparoscopic colon surgery be objectively assessed?—a scoping review

Quality of laparoscopic camera navigation in robot‐assisted versus conventional laparoscopic surgery for rectal cancer: An analysis of surgical videos through a video processing computer software

Image-based laparoscopic camera steering versus conventional steering: a comparison study

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