A task and performance analysis of endoscopic submucosal dissection (ESD) surgery

Cetinsaya, Berk; Gromski, Mark A.; Lee, Sangrock; Xia, Zhaohui; Demirel, Doga; Halic, Tansel; Bayrak, Coşkun; Jackson, C. Loring; De, Suvranu; Hegde, Sudeep; Cohen, Jonah; Sawhney, Mandeep S.; Stavropoulos, Stavros N.; Jones, Daniel B.

doi:10.1007/s00464-018-6379-6

Cited by 13 publications

(12 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The questions were organized in the order of tasks performed during ESD. This task-structure was available as a result of a hierarchical task analysis (HTA) of ESD produced by a previous study [28]. The HTA breaks down the ESD procedure into a sequence of stages from preparation to retrieval of the lesion and sending it for histopathology.…”

Section: Methodsmentioning

confidence: 99%

Endoscopic submucosal dissection: a cognitive task analysis framework toward training design

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background: One of the major impediments to the proliferation of endoscopic submucosal dissection (ESD) training in Western countries is the lack of sufficient experts as instructors. One way to address this gap is to develop didactic systems, such as surgical simulators, to support the role of trainers. Cognitive task analysis (CTA) has been used in healthcare for the design and improvement of surgical training programs, and therefore can potentially be used for design similar systems for ESD. Objective:The aim of the study was to apply a CTA-based approach to identify the cognitive aspects of performing ESD, and to generate qualitative insights for training. Materials and Methods:Semi-structured interviews were designed based on the CTA framework to elicit knowledge of ESD practitioners relating to the various tasks involved in the procedure. 3 observations were conducted of expert ESD trainers either while they performed actual ESD procedures or at a training workshop. Interviews were either conducted over the phone or in person. Interview participants included 4 experts and 4 novices. The observation notes and interviews were analyzed for emergent qualitative themes and relationships. Results:The qualitative analysis yielded thematic insights related to four main cognition-related categories: learning goals/principles, challenges/concerns, strategies, and decision-making. The specific insights under each of these categories were systematically mapped to the various tasks inherent to the ESD procedure.

show abstract

Section: Methodsmentioning

confidence: 99%

Endoscopic submucosal dissection: a cognitive task analysis framework toward training design

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…10 Multiple ESD simulators have been developed in an effort to improve technique for trainees and increase adoption. [29][30][31][32] Chen and colleagues designed a novel artificial simulator for ESD ( Fig. 1) as a bridge between instructional videos and animal tissue training and found gastroenterology fellows who participated felt more confident in performing the procedure.…”

Section: Endoscopy Simulators and Ex Vivo Modelsmentioning

confidence: 99%

“…30 Virtual Endoluminal Surgery Simulator (VESS) has also been designed in an effort to provide ESD metrics to be used for future validation studies. 31 These virtual reality simulators rely upon haptic technology (i.e. kinesthetic communication or 3-D touch) to improving training in a controlled environment and have been widely used in laparoscopic surgical training programs.…”

Section: Endoscopy Simulators and Ex Vivo Modelsmentioning

confidence: 99%

“…kinesthetic communication or 3-D touch) to improving training in a controlled environment and have been widely used in laparoscopic surgical training programs. 13,31 Training simulators using animal tissue explant have also been proven to be effective for ESD training. Due to anatomical similarities and feasibility, explanted ex vivo porcine stomachs are the most commonly used.…”

Section: Endoscopy Simulators and Ex Vivo Modelsmentioning

confidence: 99%

See 1 more Smart Citation

Current state of education and training for endoscopic submucosal dissection: Translating strategy and success to the USA

McCarty

Aihara

2020

Digestive Endoscopy

View full text Add to dashboard Cite

Endoscopic submucosal dissection (ESD) is a rigorous and technically sophisticated method for removal of lesions within the gastrointestinal tract. Despite having advantages of en‐bloc resection of lesions, regardless of size, and widespread use in Japan and Asia, ESD has not become widely adopted in the USA for a variety of reasons. Based upon Japanese education and the master‐apprentice model, modification to the education system and additional techniques designed to facilitate broader adoption are required for trainees in the USA. This article will review the current state of education and training for ESD in the USA.

show abstract

“…A pseudo surgical task was used to test the system with three hand control. Surgical procedures such as Endoscopic Submucosal Dissection (ESD) are challenging to carry out even for professional endoscopists, who require years of training to perform it skillfully [150], [151]. Therefore, to test the system and three hand operation with naive subjects, we selected as a simplified task the point cutting and marking at the specified areas using the electrosurgical unit instrument.…”

Section: Setup and Surgical Taskmentioning

confidence: 99%

Development of an intuitive foot-machine interface for robotic surgery

Huang¹

View full text Add to dashboard Cite

In robotic surgery, the surgeon controls the surgical robot through human-machine interfaces. The most common interfaces are for hands so that the surgeon can only control at most two robotic instruments at one time while three or more instruments may be needed at the same time in some procedures, e.g., robotic endoscopic/laparoscopic surgery. Current practices to these cases, i.e., having one assistant control the additional instrument, is not ideal because fine collaboration between the surgeon and the assistant is required, and delayed actions and even safety issues due to communication errors may occur. These limitations can be avoided if the surgeon could control all the tools on his/her own simultaneously. This thesis work developed a novel foot-controlled human-machine interface, enabling the surgeon to control the additional robotic surgical tool using the foot, together with the two tools that are controlled by the hands. This foot-controlled interface controls a robotic surgical instrument in continuous direction and speed based on the motion of the foot in four degrees of freedom (DoFs), i.e., foot left/right translation, forward/backward translation, lateral/medial rotation, and toe-up/down rotation. The foot force/position signals are collected through eight feedback-sensing modules of the interface surrounding the foot. Each feedback-sensing module consists of a spring and a load cell. The foot's position can be determined by the deformation of the springs which is calculated based on the forces measured by the load cells. The whole foot operation is separated into elastic and isometric modes. In the elastic mode, the springs are not fully compressed and thus the foot can move freely with reaction forces from the springs (i.e., passive force feedback); in the isometric mode, the foot's motion is limited by the boundary (some springs are fully compressed) but its force is not limited and thus can still be used for output commands. The seamless transition between the two modes provides the user with rich proprioceptive information and meanwhile enlarges input ranges that are limited only by his/her strength. The interface also features a singularityfree workspace with a neutral central home position. The weight of the foot is well supported, and the friction of the interface is minimized to limit operation fatigue.i An analytical model based on the kinematics and statics of the foot interface was derived for output command calculation; however, this model does not consider the distinct motion behaviors of different users. Therefore, a data-driven mapping approach using independent component analysis was proposed to adapt the interface to the specific user's motion pattern, which effectively reduces the deviation between users.Three studies were conducted on the developed interface: (1) Controlling of an industrial robotic arm for path-tracking and button-pressing tasks and comparison to a foot button interface. The proposed interface was about 30% faster and 60% smoother than a conventional foot butto...

show abstract

A task and performance analysis of endoscopic submucosal dissection (ESD) surgery

Abstract: We elaborated ESD tasks and developed quantitative performance metrics used in analysis of actual surgery performance. These ESD metrics will be used in future validation studies of our VESS simulator.

Cited by 13 publications

References 36 publications

Endoscopic submucosal dissection: a cognitive task analysis framework toward training design

Endoscopic submucosal dissection: a cognitive task analysis framework toward training design

Current state of education and training for endoscopic submucosal dissection: Translating strategy and success to the USA

Development of an intuitive foot-machine interface for robotic surgery

Contact Info

Product

Resources

About