Video Analysis of Otologic Instrument Movement During Resident Mastoidectomies

Abstract

ObjectiveTo measure surgical instrument movement during resident mastoidectomies and identify metrics that correlate with experience.Study DesignRetrospective case series.SettingTertiary care center.SubjectsTen postgraduate year (PGY) 2, 6 PGY3, 7 PGY4, and 19 PGY5 recordings of mastoidectomy performed by otolaryngology residents.InterventionsOne-minute intraoperative recordings of mastoidectomies performed during cochlear implantation were collected. Drill and suction-irrigator motion were analyzed with sports motion tracking software.Main Outcome MeasuresMean instrument speed, angle, and angular velocity were calculated. Mann-Whitney U tests compared mean instrument metrics between PGY levels. Change in drill speed for seven residents between their PGY2 to PGY5 years was individually analyzed.ResultsMean drill speed was significantly greater for PGY5 residents compared with PGY2s (2.9 versus 1.8 cm/s, p = 0.001). Compared with PGY2 residents, suction speed was greater as a PGY5 (1.2 versus 0.9 cm/s; p = 0.201) and significantly greater as a PGY4 (1.5 versus 0.9 cm/s, p = 0.039). Of the seven residents individually analyzed, group mean drill speed increased by 0.4 cm/s, yearly.ConclusionsDrill and suction-irrigator movement during the second minute of drilling of a cortical mastoidectomy seems to increase with resident level. Objective video analysis is a potential adjunct for differentiating novices from more experienced surgeons and monitoring surgical skills progress.

Convolutional Neural Network‐Based Deep Learning Engine for Mastoidectomy Instrument Recognition and Movement Tracking

“…Surgical education's reliance on these methods poses a risk of ineffective surgical training and graduation of incompetent surgeons. Objective analysis of surgical skills on the other hand could provide reliable and valid quantitative and qualitative feedback to surgeons‐in‐training, but up to this time, has been prohibitively time‐consuming due to technological limits of surgical video analysis 8‐10 . Surgical education could be improved upon and accelerated through the combined methods of intelligent assessment tools and guidance of skilled surgeons.…”