Video-based assistance system for training in minimally invasive surgery

Sánchez‐Margallo, Juan A.; Sánchez‐Margallo, Francisco M.; Pagador, J. Blas; Gómez, Enrique J.; Sánchez-González, Patricia; Usón, Jesús; Moreno, José A.

doi:10.3109/13645706.2010.534243

Cited by 18 publications

(14 citation statements)

References 28 publications

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“…2D tracking has been validated for assessment of basic laparoscopic tasks (eye-hand coordination task, camera manipulation task and two-handed manoeuvres) on box trainers [101,102]. 3D pose extraction has been proven feasible, based solely on the instrument's diameter and the endoscope's field of view, and validation studies as an assessment tool are currently being performed [103].…”

Section: Human Motíon Tracking In Real Settíngsmentioning

confidence: 99%

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

García

Sánchez-González

Lamata

et al. 2011

Journal of Surgical Research

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132

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Training and assessment paradigms for laparoscopic surgical skills are evolving from traditional mentortrainee tutorship towards structured, more objective and safer programs. Accreditation of surgeons requires reaching a consensus on metrics and tasks used to assess surgeons' psychomotor skills. Ongoing development of tracking systems and software Solutions has allowed for the expansión of novel training and assessment means in laparoscopy. The current challenge is to adapt and include these systems within training programs, and to exploit their possibilities for evaluation purposes. This paper describes the state of the art in research on measuring and assessing psychomotor laparoscopic skills. It gives an overview on tracking systems as well as on metrics and advanced statistical and machine learning techniques employed for evaluation purposes. The later ones have a potential to be used as an aid in deciding on the surgical competence level, which is an important aspect when accreditation of the surgeons in particular, and patient safety in general, are considered. The prospective of these methods and tools make them complementary means for surgical assessment of motor skills, especially in the early stages of training. Successful examples such as the Fundamentáis of Laparoscopic Surgery should help drive a paradigm change to structured curricula based on objective parameters. These may improve the accreditation of new surgeons, as 1 To whom correspondence and reprint requests should be addressed at Bioengineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Universidad Politécnica de Madrid (UPM). Avda Complutense, 30, 28040, Madrid, Spain. E-mail: ioropesa@gbt.tfo. upm.es. well as optimize their already overloaded training schedules.

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Section: Human Motíon Tracking In Real Settíngsmentioning

confidence: 99%

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

García

Sánchez-González

Lamata

et al. 2011

Journal of Surgical Research

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132

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“…The noninvasive and unobtrusive nature of a tracking system based on computer vision techniques makes it suitable for training purposes (both in laboratory settings and the operating room) and for image-guided surgical navigation [ 14,15]. An additional potential benefit of this approach is the possibility of an off-line analysis of recorded surgical procedures.…”

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confidence: 99%

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

et al. 2012

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“…Sin embargo, esta tarea requiere de procedimientos más automáticos, como los basados en el análisis de los movimientos del instrumental. Para el desarrollo de este tipo de sistemas, bien sea para su aplicación en cirugía guiada por imagen 21 , para cirugía robótica 22 o bien para evaluación de destrezas, se han utilizado diversas tecnologías de seguimiento como sistemas electromagnéticos 13 , mecánicos 23 , ópticos 24 o basados en vídeo 12,14 .…”

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Utilidad de un sistema de seguimiento óptico de instrumental en cirugía laparoscópica para evaluación de destrezas motoras

Sánchez‐Margallo

Pagador

et al. 2014

Cirugía Española

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RESUMENIntroducción: En este trabajo se estudia la utilidad de un sistema de evaluación de destrezas quirúrgicas basado en el análisis de los movimientos del instrumental laparoscópico. Método: El sistema consta de un simulador físico laparoscópico y un sistema de seguimiento y evaluación de habilidades técnicas quirúrgicas. En el estudio han participado 6 cirujanos con experiencia intermedia (entre 1 y 50 intervenciones laparoscópicas) y 5 cirujanos expertos (más de 50 intervenciones laparoscópicas), todos ellos con la mano derecha como dominante. Cada sujeto realizó 3 repeticiones de una tarea de corte con la mano derecha en tejido sintético, una disección de la serosa gástrica y una sutura en la disección realizada. Para cada ejercicio se analizaron los parámetros de tiempo, distancia recorrida, velocidad, aceleración y suavidad de movimientos para los instrumentos de ambas manos.Resultados: En la tarea de corte, los cirujanos expertos muestran menor aceleración (p = 0,014) y mayor suavidad en los movimientos (p = 0,023) en el uso de la tijera. Respecto a la actividad de disección, los cirujanos expertos requieren menos tiempo (p = 0,006) y recorren menos distancia con ambos instrumentos (p = 0,006 para disector y p = 0,01 para tijera). En la tarea de sutura, los cirujanos expertos presentan menor tiempo de ejecución que los cirujanos de nivel intermedio (p = 0,037) y recorren menos distancia con el disector (p = 0,041). Conclusiones: El sistema de evaluación se mostró útil en las tareas de corte, disección y sutura, y constituye un progreso en el desarrollo de sistemas avanzados de entrenamiento y evaluación de destrezas quirúrgicas laparoscópicas. Usefulness of an optical tracking system in laparoscopic surgery for motor skills assessmentABSTRACT Introduction: The objective of this study is to assess the usefulness of an evaluation system of surgical skills based on motion analysis of laparoscopic instruments. Method: This system consists of a physical laparoscopic simulator and a tracking and assessment system of technical skills in laparoscopy. Six surgeons with intermediate experience (between 1 and 50 laparoscopic surgeries) and 5 experienced surgeons (more than 50 laparoscopic surgeries) took part in this study. All participants were right-handed. The subjects performed 3 repetitions of a cutting task on synthetic tissue with the right hand, dissection of a gastric serous layer, and a suturing task in the dissection previously done. Objective metrics such as time, path length, speed of movements, acceleration and motion smoothness were analyzed for the instruments of each hand. Results: In the cutting task, experienced surgeons show less acceleration (P=.014) and a smoother motion (P=.023) using the scissors. Regarding the dissection activity, experienced surgeons need less time (P=.006) and less length with both instruments (P=.006 for dissector and P=.01 for scissors). In the suturing task, experienced surgeons require less time (P=.037) and distance travelled (P=.041) by the dissector. Conclusions: ...

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Video-based assistance system for training in minimally invasive surgery

Cited by 18 publications

References 28 publications

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

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

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

Utilidad de un sistema de seguimiento óptico de instrumental en cirugía laparoscópica para evaluación de destrezas motoras

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