The Effect of Expertise on Gaze Behaviour in Laparoscopic Cholecystectomy

Gunawardena, Nishan; Matscheko, Michael; Anzengruber, Bernhard; Ferscha, Alois; Schobesberger, Martin; Shamiyeh, Andreas; Klugsberger, Bettina; Solleder, Peter

doi:10.1109/embc.2019.8857612

Cited by 4 publications

(5 citation statements)

References 14 publications

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“…22,50,55,56 Reduced fixation rates and greater fixation durations are reported among expert surgeons. 36,37 Gaze entropy is reported to be higher with increased CWL and greater task complexity although this is contrary to findings in a cohort of fighter pilots during simulations of increased complexity. 30,45,57 To our knowledge, this is the first systematic review of published literature to summarize and synthesize the use of pupil metrics with respect to CWL in all aspects of the surgical setting.…”

Section: Discussioncontrasting

confidence: 81%

“…A further study also demonstrated that experts demonstrate higher fixation frequency and dwell time in open inguinal hernia repair surgery which can be used to differentiate between experts and novices. 18 Gunawardena et al 36,37 investigated how expertise was reflected in eye metrics during live laparoscopic cholecystectomy. Fixation and pupillary metrics were studied and compared with levels of experience to find that the most statistically significant metrics to differentiate expertise levels were the number of fixations (fewer in experts), mean fixation duration (longer in experts), and index of pupillary activity (lower in experts).…”

Section: Direct Measurement Of Cognitive Workload Expertise and Perfo...mentioning

confidence: 99%

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The Measurement of Cognitive Workload in Surgery Using Pupil Metrics: A Systematic Review and Narrative Analysis

Naik

Kogkas

Ashrafian

et al. 2022

Journal of Surgical Research

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Section: Discussioncontrasting

confidence: 81%

Section: Direct Measurement Of Cognitive Workload Expertise and Perfo...mentioning

confidence: 99%

The Measurement of Cognitive Workload in Surgery Using Pupil Metrics: A Systematic Review and Narrative Analysis

Naik

Kogkas

Ashrafian

et al. 2022

Journal of Surgical Research

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“…Together, these metrics demonstrate that force measurements can meaningfully quantify and differentiate palpation skill between HPs and LPs. It is also interesting to note that the number of T ouchpoints and T P T are similar to metrics used in an eye-tracking study measuring gaze behavior during laparoscopic surgery [40]. Our results are akin to this study where HPs had fewer "fixations" while holding each "fixation" longer than other performers.…”

Section: Discussionsupporting

confidence: 67%

Simulator-Based Metrics for Quantifying Vascular Palpation Skill for Cannulation

et al. 2022

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Palpation is essential for accurate diagnosis and treatment in many clinical examinations and procedures. Specifically, vascular palpation is used to diagnose cardiovascular health issues and identify anatomical landmarks in the peripheral vascular system. However, not much attention has been given to quantifying what comprises skilled vascular palpation; therefore, this study aims to objectively quantify the differences between high performer (HP), mid performer (MP), and low performer (LP) behavior towards understanding vascular palpation skills. Eleven HPs, ten LPs, and twenty-five MPs completed sixteen trials on our simulator under various conditions. There were four fistulas, two skin thicknesses, and two motor vibration intensities. Finger force and location data were recorded for each trial on the simulator. We examined three types of palpation metrics: time, force, and location. All three types of metrics demonstrated statistically significant differences between HP and LP palpation behavior. Therefore, these metrics could be used for structured and standardized palpation skills training in the future, potentially improving patient outcomes.

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“…Head mounted devices have the advantage of consistently capturing eye-data regardless of the direction the user is looking. Since only six of the included studies involved implementing head-mounted devices while the user was 'scrubbed in', 44,45,52,55,58,59 there is a need for further research to demonstrate the feasibility of using these systems in a sterile environment. Remote devices appear to be suitable for laparoscopic procedures as they can be placed adjacent to the screen and are therefore relatively likely to detect corneal direction.…”

Section: Discussionmentioning

confidence: 99%

“…Pupillometric data can be a valuable marker of cognitive workload in laparoscopic settings. Measures such as pupil size, maximum pupil size, pupil size rate of change, percentage of change and Index of Cognitive Activity (ICA) have been assessed 17,52– 59 . Gao et al .…”

Section: Assessment Domainmentioning

confidence: 99%

Eye‐tracking in surgery: a systematic review

Bapna,

Valles,

Leng

et al. 2023

ANZ Journal of Surgery

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BackgroundSurgery is constantly evolving with the assistance of rapidly developing novel technology. Eye‐tracking devices provide opportunities to monitor the acquisition of surgical skills, gain insight into performance, and enhance surgical practice. The aim of this review was to consolidate the available evidence for the use of eye‐tracking in the surgical disciplines.MethodsA systematic literature review was conducted in accordance with PRISMA guidelines. A search of OVID Medline, EMBASE, Cochrane library, Scopus, and Science Direct was conducted January 2000 until December 2022. Studies involving eye‐tracking in surgical training, assessment and technical innovation were included in the review. Non‐surgical procedures, animal studies, and studies not involving surgical participants were excluded from the review.ResultsThe search returned a total of 12 054 articles, 80 of which were included in the final analysis and review. Seventeen studies involved eye‐tracking in surgical training, 48 surgical assessment, and 20 were focussing on technical aspects of this technology. Twenty‐six different eye‐tracking devices were used in the included studies. Metrics such as the number of fixations, duration of fixations, dwell time, and cognitive workload were able to differentiate between novice and expert performance. Eight studies demonstrated the effectiveness of gaze‐training for improving surgical skill.ConclusionThe current literature shows a broad range of utility for a variety of eye‐tracking devices in surgery. There remains a lack of standardization for metric parameters and gaze analysis techniques. Further research is required to validate its use to establish reliability and create uniform practices.

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The Effect of Expertise on Gaze Behaviour in Laparoscopic Cholecystectomy

Cited by 4 publications

References 14 publications

The Measurement of Cognitive Workload in Surgery Using Pupil Metrics: A Systematic Review and Narrative Analysis

The Measurement of Cognitive Workload in Surgery Using Pupil Metrics: A Systematic Review and Narrative Analysis

Simulator-Based Metrics for Quantifying Vascular Palpation Skill for Cannulation

Eye‐tracking in surgery: a systematic review

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